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Multicenter Study
. 2023 Jul;308(1):117-125.
doi: 10.1007/s00404-022-06712-z. Epub 2022 Aug 2.

Intrauterine transfusion in 103 fetuses with severe anemia caused by parvovirus infection. A multicenter retrospective study

Philipp Kosian  1 , Astrid Hellmund  2 , Annegret Geipel  3 , Rainer Bald  4 , Otilia-Maria Geist  4 , Paul Böckenhoff  3 , Jorge Jimenez-Cruz  3 , Maria Deja  3 , Brigitte Strizek  3 , Christoph Berg  3   5 , Ulrich Gembruch  3
Affiliations
Multicenter Study

Intrauterine transfusion in 103 fetuses with severe anemia caused by parvovirus infection. A multicenter retrospective study

Philipp Kosian et al. Arch Gynecol Obstet. 2023 Jul.

Abstract

Purpose: Evaluating procedure-related complications and perinatal outcomes after intrauterine transfusion (IUT) before or after 20+0 weeks of gestation in fetuses with severe anemia due to intrauterine human parvovirus B19 infection.

Methods: A retrospective study investigating fetuses requiring IUT for fetal Parvo B19 infection in two tertiary referral centers between December 2002 and December 2021. Procedure-related complications, intrauterine fetal death (IUFD), and perinatal outcome were correlated to gestational age (GA) at first IUT, the presence of hydrops and fetal blood sampling results.

Results: A total of 186 IUTs were performed in 103 fetuses. The median GA at first IUT was 19+3 (13+0-31+4) weeks of gestation. IUFD occurred in 16/103 fetuses (15.5%). Overall survival was 84.5% (87/103). Hydrops (p = 0.001), lower mean hemoglobin at first IUT (p = 0.001) and low platelets (p = 0.002) were strongly associated with IUFD. There was no difference observed in fetuses transfused before or after 20+0 weeks of gestation.

Conclusion: IUT is a successful treatment option in fetuses affected by severe anemia due to parvovirus B19 infection in specialized centers. In experienced hands, IUT before 20 weeks is not related to worse perinatal outcome.

Keywords: Fetal anemia; Fetal hydrops; Fetal infection by parvovirus B19; Fetal therapy; Intrauterine transfusion.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Hemoglobin concentration in g/dl before first intrauterine transfusion in cases of surviving versus non-surviving fetuses
Fig. 2
Fig. 2
Platelet count before first intrauterine transfusion in cases of surviving versus non-surviving fetuses
See this image and copyright information in PMC

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