Samiya Naeemullah, Yasmin Rashid, Muhammad Naeemullah.
Severe Rh (D) Immunization, Treatment Possibilities of Neonates Born after Intrauterine Intravascular Transfusions.
J Rawal Med Coll Jan ;5(1):3-6.

Rapid progress has been made in the management of Rh-D immunization. Intrauterine intravascular transfusion in pregnancy has developed as a therapeutic modality to save hydropic fetuses. The intrauterine intravascular transfusions are being done for the first time in Pakistan. These transfusions are done in utero under Doppler ultrasound guidance. The Neonatal management and follow up of these neonates is presented, born between July 1998 to April 2000. The oldest infants among them is 2 Years and 5. months as of December 2000. Since this an ongoing process the neonatal management and follow up of five infants at moment is presented. The mothers of these infants had bad obstetric histories. All had H/O abortions, intrauterine deaths & neonatal deaths & one mother was Gravida-16 Para 7 with five neonatal deaths. The number of intrauterine intra vascular transfusion varied between 2-7 in different pregnancies. All neonates were born by cesarean section (C section) with gestational ages of 35-37 weeks with good apgar scores. Their weights ranged between 2.4 kg to 3.5 kg Four neonates required exchange transfusion, four required whole blood transfusion and one needed platelet transfusion during neonatal stay. The maximum number of stay in neonatal intensive care unit was 7 days with good recovery. Top up transfusions were needed in four infants to maintain Hemoglobin (Hb levels). The last transfusion coincided with reversion to original blood groups within average of 120 days .The infants maintained normal developmental mile stones with no childhood illnesses.

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