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- Title
Persistent pulmonary hypertension of the newborn after fetomaternal hemorrhage.
- Authors
Gijtenbeek, Manon; Lopriore, Enrico; Steggerda, Sylke J.; Te Pas, Arjan B.; Oepkes, Dick; Haak, Monique C.
- Abstract
<bold>Background: </bold>Newborns with anemia are at increased risk of persistent pulmonary hypertension of the newborn (PPHN), yet reports on the association between fetomaternal hemorrhage (FMH) and PPHN are rare. To optimize care for pregnancies complicated by FMH, clinicians should be aware of the risks of FMH and the possible diagnostic and therapeutic options. To increase the current knowledge, the incidence of PPHN and short-term neurologic injury in FMH cases were studied.<bold>Study Design and Methods: </bold>We included all FMH cases (≥30 mL fetal blood transfused into the maternal circulation) admitted to our neonatal unit between 2006 and 2018. First, we evaluated the incidence of PPHN and short-term neurologic injury. Second, we studied the potential effect of intrauterine transfusion (IUT).<bold>Results: </bold>PPHN occurred in 37.9% of newborns (11 of 29), respectively, 14.3% (one of seven) and 45.5% (10 of 22) in the IUT group and no-IUT group (p = 0.20). The mortality rate was 13.8% (4 of 29). Severe brain injury occurred in 34.5% (10 of 29), respectively, and 14.3% (one of seven) and 40.9% (nine of 22) in the IUT group and no-IUT group (p = 0.37).<bold>Conclusion: </bold>Awareness should be raised among perinatologists and neonatologists about the possible life-threatening consequences of FMH, as more than one-third of neonates with anemia due to FMH experience PPHN and suffer from severe brain injury. Antenatal treatment with IUT seems to reduce these risks. Specialists should therefore always consider fetal anemia in FMH cases and refer patients to a fetal therapy center. If anemia is present at birth, it should be corrected promptly and neonatologists should be aware of signs of PPHN.
- Subjects
PERSISTENT fetal circulation syndrome; NEONATAL anemia; VERTICAL transmission (Communicable diseases); INTRAUTERINE blood transfusion; HYPOXEMIA; BRAIN injury treatment; PULMONARY hypertension treatment; BRAIN injuries; CLINICAL trials; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; PULMONARY hypertension; RESEARCH; EVALUATION research; DISEASE complications; THERAPEUTICS
- Publication
Transfusion, 2018, Vol 58, Issue 12, p2819
- ISSN
0041-1132
- Publication type
journal article
- DOI
10.1111/trf.14932