Effect of intrauterine transfusion on neonatal outcomes in rh hemolytic disease

Abstract

Introduction: The aim of this study was to evaluate the neonates with Rh hemolytic disease according to the severity of hemolytic disease (slight, moderate and severe) and the presence of intrauterine transfusion (IUT) for necessity of postnatal exchange transfusion or phototherapy application and severity of neonatal anemia.Materials and Method: The neonates admitted to Neonatal Intensive Care Unit with Rhesus hemolytic disease between January 2000 and November 2008 were included in this retrospective study. Cord blood hemoglobine and bilirubin levels, reticulocyte count, maximum bilirubin level, number of intrauterine transfusion, duration of phototherapy, requirement of postnatal exchange transfusion or redblood cell transfusions were all recorded.Results: A total of 44 neonates were included in the study. The mean gestational age and birth weight of infants were 37.6 +/- 0.3 week and 3031 +/- 53 g, respectively. Slight, moderate and severe hemolytic disease was determined in 13 (29.5%), 13 (29.5%) and 18 (41%) of infants, respectively. IUT was performed in 12 infants (27%) and 9 of them (75%) had severe hemolytic disease and this ratio was significantly higher compared with the infants without IUT. Similarly, requirement of postnatal exchange transfusion was also higher in infants who had IUT compared with the infants who did not have IUT. No significant difference was determined between infants with and without IUT in terms of duration of phototherapy, maximum bilirubin levels and transfusion requirement.Conclusion: The incidence of severe hemolytic disease and postnatal exchange requirement were significantly higher in infants with IUT compared with the infants without IUT. Therefore, it is concluded that if Rhesus hemolytic disease is severe in utero, it may present as severe hemolytic disease in the postnatal period.