Articles Vol. 66 No. Vol 67. English Version No 2 11/06/2026

OUTCOMES OF INTRAUTERINE TRANSFUSION FOR FETAL ANEMIA: A CASE SERIES AT HANOI OBSTETRICS AND GYNECOLOGY HOSPITAL

Phan Thi Huyen Thuong1,2, Vu Thi Kim Ngan1
1 Hanoi Obstetrics and Gynecology Hospital
2 VNU University of Medicine and Pharmacy
DOI: 10.52163/yhc.v66ii8.5290
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Keywords
Intrauterine transfusion, fetal anemia, fetal medicine.
Abstract

Objective: To describe the outcomes of intrauterine transfusion for fetal anemia at Hanoi Obstetrics and Gynecology Hospital.

Materials and Methods: A prospective case series study was conducted on 05 fetuses diagnosed with severe anemia indicated for ultrasound-guided intrauterine transfusion (IUT) at the Fetal Intervention Center, Hanoi Obstetrics and Gynecology Hospital.

Results: The mean gestational age at the time of intervention was 29.05 ± 2.43 weeks. The study recorded that 100% of cases achieved target hemoglobin (Hb) levels after a single transfusion. The mean Middle Cerebral Artery Peak Systolic Velocity (MCA-PSV) decreased from 1.91 ± 0.14 MoM pre-intervention to 1.43 ± 0.08 MoM post-intervention. Following the procedure, 4/5 fetuses achieved prolonged survival. The mean gestational age at birth was 29 weeks 6 days ± 23.8 days. The mean 1-minute Apgar score was 5.8 ± 3.35. Poor prognostic factors included: early gestational age at transfusion, fetal hydrops, low pre-transfusion hemoglobin, high MCA-PSV, and the occurrence of procedure-related complications.

Conclusion: Intrauterine transfusion is an effective treatment that provides immediate improvement in fetal hematological and hemodynamic status, offering an opportunity to prolong the pregnancy. The results confirm the feasibility of this technique at a tertiary specialized facility while emphasizing the role of early detection and timely intervention before the progression to severe fetal hydrops.

References
[1]
Prefumo F, Fichera A, Fratelli N, Sartori E. Fetal anemia: Diagnosis and management. Best Pract Res Clin Obstet Gynaecol. 2019; 58:2-14. doi: 10.1016/j.bpobgyn.2019.01.001 Google Scholar
[2]
Liley AW. Intrauterine Transfusion of Foetus in Haemolytic Disease. Br Med J. 1963;2(5365):1107-1109. Google Scholar
[3]
Zwiers C, Oepkes D, Lopriore E, Klumper FJ, de Haas M, van Kamp IL. The near disappearance of fetal hydrops in relation to current state‐of‐the‐art management of red cell alloimmunization. Prenat Diagn. 2018;38(12):943-950. doi:10.1002/pd.5355 Google Scholar
[4]
Picklesimer AH, Oepkes D, Moise KJ, et al. Determinants of the middle cerebral artery peak systolic velocity in the human fetus. Am J Obstet Gynecol. 2007;197(5): 526.e1-526.e4. doi: 10.1016/j.ajog.2007.04.002 Google Scholar
[5]
Enders, M., Weidner, A., Zoellner, I., Searle, K. and Enders, G. (2004), Fetal morbidity and mortality after acute human parvovirus B19 infection in pregnancy: prospective evaluation of 1018 cases. Prenat. Diagn., 24: 513-518. https://doi.org/10.1002/pd.940 Google Scholar
[6]
Van Kamp, Inge L., et al. Complications of intrauterine intravascular transfusion for fetal anemia due to maternal red-cell alloimmunization. American Journal of Obstetrics & Gynecology, Volume 192, Issue 1, 171 – 177 Google Scholar
[7]
Cahen Peretz A, Tsaitlin-Mor L, Leibner G, et al. Late vs. early intrauterine blood transfusion in fetal anemia: impact on maternal and neonatal outcomes. Front Med (Lausanne). 2025 Sep 5;12:1614989. doi: 10.3389/fmed.2025.1614989. Google Scholar
[8]
Blyth U, Larsson M, Baird A, et al. Neonatal outcomes following intrauterine transfusion for hemolytic disease of the fetus and newborn: a twenty-year service review. J Matern Fetal Neonatal Med. 2022 Dec;35(25):10220-10225. doi: 10.1080/14767058.2022.2122041. Epub 2022 Sep 18. Google Scholar
[9]
Pares DBDS, Pacheco GHAS, Lobo GAR. Intrauterine Transfusion for Rhesus Alloimmunization: A Historical Retrospective Cohort from A Single Reference Center in Brazil. J Clin Med. 2024 Feb 28;13(5):1362. doi: 10.3390/jcm13051362. Google Scholar