Intrauterine transfusion and non-invasive treatment options for hemolytic disease of the fetus and newborn - review on current management and outcome

Expert Rev Hematol. 2017 Apr;10(4):337-344. doi: 10.1080/17474086.2017.1305265. Epub 2017 Mar 20.

Abstract

Hemolytic disease of the fetus and newborn (HDFN) remains a serious pregnancy complication which can lead to severe fetal anemia, hydrops and perinatal death. Areas covered: This review focusses on the current prenatal management, treatment with intrauterine transfusion (IUT) and promising non-invasive treatment options for HDFN. Expert commentary: IUTs are the cornerstone in prenatal management of HDFN and have significantly improved perinatal outcome in the past decades. IUT is now a relatively safe procedure, however the risk of complications is still high when performed early in the second trimester. Non-invasive management using intravenous immunoglobulin may be a safe alternative and requires further investigation.

Keywords: Fetal anemia; fetal therapy; hemolytic disease of the fetus and newborn; intrauterine blood transfusion; intravenous immunoglobulin; therapeutic plasma exchange and red cell alloimmunization in pregnancy.

Publication types

  • Review

MeSH terms

  • Anemia, Hemolytic / diagnosis
  • Anemia, Hemolytic / etiology
  • Anemia, Hemolytic / therapy*
  • Blood Transfusion, Intrauterine* / adverse effects
  • Blood Transfusion, Intrauterine* / methods
  • Combined Modality Therapy* / adverse effects
  • Combined Modality Therapy* / methods
  • Disease Management
  • Female
  • Fetal Diseases / diagnosis
  • Fetal Diseases / etiology
  • Fetal Diseases / therapy*
  • Fetal Therapies* / adverse effects
  • Fetal Therapies* / methods
  • Hemolysis*
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / diagnosis
  • Infant, Newborn, Diseases / etiology
  • Infant, Newborn, Diseases / therapy*
  • Pregnancy
  • Treatment Outcome