Resumo

GONZALEZ ARIAS, Freddy; PARAVISINI, Iván; MORALES, Jazmín  e  VASQUEZ DE MARTINEZ, Nelly. Transfusión intrauterina intravascular . Rev Obstet Ginecol Venez [online]. 2006, vol.66, n.2, pp.67-75. ISSN 0048-7732.

Objective: To present the results of 90 intrauterine intravascular transfusions performed in 45 Rh isoinmunized fetuses. Method: Description of the intrauterine intravascular transfusion´s procedure and presentation of evaluation and prospective floow up of 90 transfusions practiced from 1995 to 2002. Setting: High Risk Unit of Prenatal Service at Maternidad Concepción Palacios. Caracas. Results: The mean age of patients was 25.8 years; the number of transfusions ranged from one to tour (the mean was two); most patients had important records of fetal death and hemolytic disease; transfusion was mainly prescribed after optical density values followed by fetal hydrops. Gestational age for the first procedure was 25.6 weeks with a minimum of 20 weeks; fetal haemoglobin values prior to the first transfusion ranged between 2-11.3 g/dL increasing to 5-15.3 g/dL post transfusion. Total survival was 69 % and increased to 84.37 % in the nonhydropic group. Conclusion: Prevention using antiRhD inmunoglobulin is definitively the best protocol when avoiding fetal anaemia due to Rh isoimmunization. When intrauterine hemolytic disease occurs, blood transfusion through umbilical cord seems to be the best option. In our experience, we confirmed that the accumulation of experience in intrauterine intravascular transfusion is needed in order to extend intrauterine life and so achieve a higher neonatal outcome along with less risk and complications.

Palavras-chave : Transfusion; Anaemia; Isoimmunization.