Article ; Online: Severity of haemolytic disease of the fetus and newborn in patients with a history of intrauterine transfusions in a previous pregnancy: A nationwide retrospective cohort study.
BJOG : an international journal of obstetrics and gynaecology
2023 Volume 131, Issue 6, Page(s) 769–776
Abstract: Objective: Pregnant women who received at least one intrauterine transfusion (IUT) for haemolytic disease of the fetus and newborn (HDFN) in the preceding pregnancy are presumed to have a high likelihood of requiring IUTs again, often starting at an ... ...
| Abstract | Objective: Pregnant women who received at least one intrauterine transfusion (IUT) for haemolytic disease of the fetus and newborn (HDFN) in the preceding pregnancy are presumed to have a high likelihood of requiring IUTs again, often starting at an earlier gestational age. Our aim was to quantify these risks in a large national cohort. Design: Retrospective cohort study of a nationwide Dutch database. Setting: The Netherlands. Population: All women treated in The Netherlands with IUTs for Rhesus D (RhD)- or Kell-mediated HDFN between 1999 and 2017 and their follow-up pregnancies were included. Pregnancies with an antigen-negative fetus were excluded. Methods: Electronic patient files were searched for the number and gestational age of each IUT, and analysed using descriptive statistics and linear regression. Main outcome measures: Percentage of women requiring one or more IUTs again in the subsequent pregnancy, and gestational age at first IUT in both pregnancies. Results: Of the 321 women in our study population, 21% (69) had a subsequent ongoing pregnancy at risk. IUTs were administered in 86% (59/69) of cases. In subsequent pregnancies, the median gestational age at first IUT was 3 weeks earlier (interquartile range -6.8 to 0.4) than in the preceding pregnancy. Conclusions: Our study shows that pregnant women with a history of IUTs in the previous pregnancy are highly likely to require IUTs again, and on average 3 weeks earlier. Clinicians need to be aware of these risks and ensure timely referral, and close surveillance from early pregnancy onwards. Additionally, for women with a history of IUT and their caregivers, this information is essential to enable adequate preconception counselling. |
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| MeSH term(s) | Infant, Newborn ; Humans ; Female ; Pregnancy ; Blood Transfusion, Intrauterine ; Retrospective Studies ; Erythroblastosis, Fetal/epidemiology ; Erythroblastosis, Fetal/therapy ; Fetus ; Gravidity |
| Language | English |
| Publishing date | 2023-09-24 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 2000931-8 |
| ISSN | 1471-0528 ; 0306-5456 ; 1470-0328 |
| ISSN (online) | 1471-0528 |
| ISSN | 0306-5456 ; 1470-0328 |
| DOI | 10.1111/1471-0528.17674 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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