Evaluation of Perinatal Outcomes in Early Severely Alloimmunised Pregnancies

The study aimed to assess the perinatal outcomes of pregnancies with early severe alloimmunization. This was a prospective observational study comparing Rh alloimmunised women who underwent intrauterine transfusion (IUT) before 26 weeks of gestation with those who had the procedure after this period. Key outcomes analyzed included abortion rates, stillbirths, perinatal survival, and neonatal outcomes. Early transfusions predominantly utilized a thinner 22G needle and the intrahepatic route.

The outcomes of the study demonstrated:

• Out of 44 patients, 22 received early transfusions.
• In total, 152 IUTs were administered across both groups, with an average of 4.5 IUTs for the early group and 2.2 for the late group. 
• The early group experienced two abortions, while one stillbirth occurred in each group, and the late group had three neonatal deaths.
• Hydropic fetuses treated early had a higher survival rate (80%) compared to those treated later (66%).
• The take-home baby rate was also higher in the early group at 86.3%, compared to 82.6% in the late group.

In conclusion, with appropriate techniques and skills, early IUT can minimize complications and enhance survival rates, yielding results comparable to those of late transfusions. Early diagnosis and treatment significantly improve the survival chances of hydropic fetuses.

Source: Bains K, Saha SC, Aggarwal N. et al. Outcome of Early Severe Alloimmunised Pregnancies. J Obstet Gynecol India (2025). https://doi.org/10.1007/s13224-024-02081-6