• Asma Alkhaibary, Mohannad Ali, Maha Tulbah, Maha Al-Nemer, Rubina M Khan, Maisoon Al Mugbel, Nada Al Sahan, Marwah Mazen Hassounah, Waleed Alshammari, and Wesam I Kurdi.
• From the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
• Ann Saudi Med. 2021 Nov 1; 41 (6): 313-317.

BackgroundIntravascular intrauterine transfusion (IUT) is considered a safe procedure, but complications still occur, including fatalities.ObjectiveReview the outcomes of Rh alloimmunization, including indications and possible complications.DesignRetrospective cohort (medical record review).SettingTertiary care center.Patients And MethodsWe retrieved the records for all mothers who had an IUT for Rh alloimmunization between January 2009 and August 2019. We collected data on complications, post-transfusion hemoglobin and antibody combinations.Main Outcome MeasureComplications of IUT.Sample Size119 mothers with 154 fetuses (154 different pregnancies).ResultsThe 154 fetuses had 560 intrauterine transfusions. The median pre-IUT hemoglobin was a median of 8.0 g/dL while the median post-IUT hemoglobin 16 g/dL. Immediate procedure-related complications included fetal bradycardia in 2.7%, significant bleeding from the cord puncture site (for more than 2 minutes in 0.9%), and contractions in 0.9%. Eight (5.2%) were delivered by cesarean delivery due to IUT-specific complications such as post-procedure fetal bradycardia. Intrauterine fetal death complicated 8.4% of the pregnancies (13 fetuses). Phototherapy was required in 76 (49.4%), postnatal blood transfusions in 17 (11%), and exchange transfusion in 11 (7.1%). Neonatal death occurred 8 (5.2%). Data were insufficient to assess associations of complications with antibody combinations.ConclusionsIntrauterine transfusion is an effective treatment with high survival rates (around 90% for cases of Rh alloimmunization).LimitationsCase series.Conflict Of InterestNone.

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