Practice patterns amongst fetal centers performing intrauterine transfusions (PACT)

TY - JOUR

T1 - Practice patterns amongst fetal centers performing intrauterine transfusions (PACT)

T2 - An international survey study

AU - Donepudi, Roopali

AU - Antolin, Eugenia

AU - Molina, Francisca

AU - Sananes, Nicolas

AU - Khalil, Asma

AU - Abbasi, Nimrah

AU - Sánchez-Durán, M A

AU - Hecher, Kurt

AU - Fabietti, Isabella

AU - Jouannic, Jean-Marie

AU - Ortiz, Javier U

AU - Borrell, Antoni

AU - Gielchinski, Yuval

AU - Cortes, Magdalena Sanz

N1 - Copyright © 2022 Elsevier B.V. All rights reserved.

PY - 2022/7

Y1 - 2022/7

N2 - OBJECTIVES: Fetal anemia secondary to incompatibility between maternal-fetal blood types can result in hydrops and demise. Intrauterine transfusions have improved survival in experience centers. Our objective was to determine the practice patterns amongst fetal centers.STUDY DESIGN: Thirteen fetal centers across the world were surveyed. Results from all participating centers were recorded, analyzed, and presented as ratios. Questions on the survey were related to experience of the physician, preferred methods of transfusion, fetal surveillance, and timing of delivery.RESULTS: Differences amongst centers were as follows: 54% of the centers performed transfusions in operating room, the remaining did them in a clinic room or close to the operating room; 31% did not use maternal anesthesia, 31% used oral or intravenous sedation and 38% used a combination of local with oral or intravenous sedation. The similarities include: 84% performed intravenous transfusions, while 2 centers reported intraperitoneal and intracardiac transfusions were performed for very early cases; 85% of centers performed the last transfusion at 34-35 weeks and 77% electively delivered their patients at 37 weeks.CONCLUSION: Method of transfusion and delivery timing was similar in most centers; however, differences were seen in location of procedure, anesthetic coverage, and surveillance. Further assessment is needed to determine if these differences in practice have any potential neonatal effects.

AB - OBJECTIVES: Fetal anemia secondary to incompatibility between maternal-fetal blood types can result in hydrops and demise. Intrauterine transfusions have improved survival in experience centers. Our objective was to determine the practice patterns amongst fetal centers.STUDY DESIGN: Thirteen fetal centers across the world were surveyed. Results from all participating centers were recorded, analyzed, and presented as ratios. Questions on the survey were related to experience of the physician, preferred methods of transfusion, fetal surveillance, and timing of delivery.RESULTS: Differences amongst centers were as follows: 54% of the centers performed transfusions in operating room, the remaining did them in a clinic room or close to the operating room; 31% did not use maternal anesthesia, 31% used oral or intravenous sedation and 38% used a combination of local with oral or intravenous sedation. The similarities include: 84% performed intravenous transfusions, while 2 centers reported intraperitoneal and intracardiac transfusions were performed for very early cases; 85% of centers performed the last transfusion at 34-35 weeks and 77% electively delivered their patients at 37 weeks.CONCLUSION: Method of transfusion and delivery timing was similar in most centers; however, differences were seen in location of procedure, anesthetic coverage, and surveillance. Further assessment is needed to determine if these differences in practice have any potential neonatal effects.

KW - Anemia

KW - Blood Transfusion, Intrauterine/methods

KW - Female

KW - Fetal Blood

KW - Fetal Diseases/therapy

KW - Fetus

KW - Humans

KW - Infant, Newborn

KW - Pregnancy

U2 - 10.1016/j.ejogrb.2022.05.027

DO - 10.1016/j.ejogrb.2022.05.027

M3 - SCORING: Journal article

C2 - 35661539

VL - 274

SP - 171

EP - 174

JO - EUR J OBSTET GYN R B

JF - EUR J OBSTET GYN R B

SN - 0301-2115

ER -