Evaluation of Gasometric Behavior of Transfused
Fetuses in Alloimmunized Pregnant Women According
to the Concentration of Circulating Adult Hemoglobin
Volume 1 - Issue 4
Naeme Jose de Sa Filho1* and Alamanda Kfoury Pereira2
-
Author Information
Open or Close
- 1Master Student, Women’s Health Postgraduate Program, Federal University of Minas Gerais
- 2Department of Obstetrics and Gynecology, Federal University of Minas Gerais
*Corresponding author:
Naeme José de Sá Filho, Departament of Obstetrics and Gynecology, Federal University of Minas Gerais, Av. Prof.
Alfredo Balena, 190 - sala 213, Belo Horizonte - MG ZIP CODE 29043-900
Received: February 02, 2018; Published: February 21, 2018
DOI: 10.32474/IGWHC.2018.01.000116
Full Text
PDF
To view the Full Article Peer-reviewed Article PDF
Abstract
Introduction: Perinatal hemolytic disease occurs due to the passage of antibodies from maternal to fetal circulation through
the placenta; this leads to fetal erythrocytes hemolysis and death (in extreme cases). Regarding the treatment by intrauterine
transfusion, little is known about the effect of the concentration of transfused adult red blood cells on the hemodynamics and gas
exchanges in the fetal blood.
Objective: to compare the gasometric values between fetuses with gradual elevation of adult hemoglobin (HbA) concentration
after intrauterine transfusion and anemic fetuses with only fetal hemoglobin (HbF).
Methods: a longitudinal observational study was carried out from 1998 to 2015 with 365 transfusions performed on 143
fetuses. The HbF concentration was determined by the Kleihauer-Betke test and pH, pCO2, pO2, SatO2, HCO3 and BE values were
obtained from umbilical cord venous blood. The cases were ordered according to the deficit of Hb concentration in comparison with
normality curve given for each gestational age.
Results: the gradual substitution of fetal by adult red blood cells did not significantly influenced the gasometric parameters
for both Hb deficit lower than 5 g/dL [pH (p=0.958), pCO2 (p=0.400), pO2 (p=0.493), SatO2 (p=0.698), HCO3 (p=0.495) and BE
(p=0.522)] and higher than 5 g/dL [pH (p=0.601), pCO2 (p=0.065), pO2 (p=0.770), SatO2 (p=0.096), HCO3 (p=0.096) and BE
(p=0.525)].
Conclusions: Due to the existence of a hematological system with great capacity of metabolic balance, no associations between
gasometric parameters and the percentage of HbF replacement were observed; this, regardless the degree of anemia resulted from
Hb deficit
Keywords: Perinatal Hemolytic Disease; Maternal alloimmunization; Intrauterine transfusion; Fetal gasometry; Kleihauer; Fetal
hemoglobin
Abstract|
Introduction|
Methods|
Results|
Discussion|
Conclusion|
References|