Noninvasive Diagnosis of Fetal Anemia and Fetal Intravascular Transfusion Therapy: Experiences at Siriraj Hospital
Tuangsit Wataganara MD*, Booraya Wiwanichayakul MD*, Pornpimol Ruengwuttilert MD, PhD*, Prasert Sunsaneevithayakul MD*, Sommai Viboonchart BN*, Charnchai Wantanasiri MD*
Affiliation : * Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University
Traditionally, when fetal hydrops are found along with certain markers indicating fetal anemia, fetal blood sampling would be performed through cordocentesis to confirm the diagnosis. This procedure, however, comes with an inherent risk of losing the whole pregnancy. When anemia was verified, treatment options were limited and the prognosis was grim. In this article, the authors described their experiences of using prenatal Doppler studies as a noninvasive venue in the diagnosis and treatment of fetal anemia. Once the diagnosis of fetal anemia is made, the patient will be asked to undergo an algorithm to investigate the definite cause of anemia, along with simultaneous ultrasound-guided intravascular fetal transfusion in selected cases. The authors selected two cases of fetal anemia of different etiologies and treatment outcomes to demonstrate the significance of early diagnosis and intervention. Review of the relevant medical literatures and the proposed algorithms were also provided.
Keywords : Hydrop fetalis, Fetal anemia, Fetal therapy, Isoimmunization, In utero transfusion
