Abstract
We performed spectrophotometric analyses (technique of Liley) on 595 amniotic fluid specimens from 310 Rh-sensitized women; 1 or more specimens from 84 women had concentrations of pigment above levels which are generally considered to predict, with 95 % confidence, intrauterine death before 34 weeks gestation; 30 of these 84 fetuses were not transfused and 18 were liveborn (gest. age 34 weeks, SD 1.9,) of whom 9 (30 %) survived. We transfused 54 infants in utero (IUT) on 96 occasions. Of these, 25 had marked ascites at the time of transfusion: 13 died in utero, within 48 h of the procedure; 11 were born alive (gest. age 32.2 weeks, SD 2.1), were hydropic and died of the respiratory distress syndrome (RDS) in the neonatal period; 1 (4 %) was not hydropic at birth and survived. 29 did not have ascites at the time of transfusion: 13 died in utero, 12 within 48 h of the procedure; 6 were borne alive (gest. age 33 weeks; SD 1.3) and were hydropic, of whom 4 survived and 2 died with RDS; 10 were born alive (gest. age 34.6 weeks, SD 1.6) without hydrops, 1 died with RDS and 9 survived (45 %). We conclude that serial spectrophotometric analysis of amniotic fluid is required to adequately establish the need for IUT since single or paired analyses may be misleading, and that an intrauterine transfusion, particularly in an infant with ascites or performed earlier than 26 weeks gestation carriers a high mortality. (Supported by USPHS Grant HE-06285) (APS)
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Johnson, P., Margolis, A., Fong, S. et al. 60 Indications for and Consequences of Intrauterine Transfusions. Pediatr Res 1, 215–216 (1967). https://doi.org/10.1203/00006450-196705000-00067
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DOI: https://doi.org/10.1203/00006450-196705000-00067