{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T22:06:51Z","timestamp":1792534011632,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,8,7]],"date-time":"2017-08-07T00:00:00Z","timestamp":1502064000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Sanquin, Amsterdam"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2017,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n \n Maternal alloimmunization to fetal red\u2010blood\u2010cell antigens is a major cause of fetal anemia, which can lead to hydrops and perinatal death if untreated. The cornerstone of management during pregnancy is intrauterine intravascular blood transfusion (\n IUT<\/jats:styled-content>\n ). Although this procedure is considered relatively safe, complications continue to occur. The aim of this study was to evaluate rates of procedure\u2010related complications and perinatal loss following\n IUT<\/jats:styled-content>\n , and their change over time, in order to identify factors leading to improved outcome.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This was a retrospective analysis of all\n IUTs<\/jats:styled-content>\n for red\u2010cell alloimmunization performed at the national referral center for fetal therapy in The Netherlands, from 1988 to 2015. Differences in complication rates and their associations with alterations in transfusion technique after 2001 were assessed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Between 1988 and 2015, 1678\n IUTs<\/jats:styled-content>\n were performed in 589 fetuses. For\n IUTs<\/jats:styled-content>\n performed in 2001 and onwards, there was significant improvement in survival (88.6%\n vs<\/jats:italic>\n 97.0%,\n P <<\/jats:italic>\n 0.001) and a decline in procedure\u2010related complications per fetus (9.8%\n vs<\/jats:italic>\n 3.3%,\n P =<\/jats:italic>\n 0.001) and per procedure (3.4%\n vs<\/jats:italic>\n 1.2%,\n P =<\/jats:italic>\n 0.003) compared with those performed before 2001. Procedure\u2010related perinatal loss declined from 4.7% to 1.8% per fetus (\n P<\/jats:italic>\n = 0.053). Beneficial changes in transfusion technique were routine use of fetal paralysis, increased use of intrahepatic transfusion and avoidance of arterial puncture.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n IUT<\/jats:styled-content>\n has become an increasingly safe procedure in recent years when performed by experienced hands. The chosen technique should be fine\u2010tuned according to the patient's individual situation. The declining complication rates are most likely related to center volume: this rare procedure is best performed in experienced fetal therapy centers. \u00a9 2016 Authors.\n Ultrasound in Obstetrics & Gynecology<\/jats:italic>\n published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.17319","type":"journal-article","created":{"date-parts":[[2016,10,12]],"date-time":"2016-10-12T15:09:05Z","timestamp":1476284945000},"page":"180-186","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":183,"title":["Complications of intrauterine intravascular blood transfusion: lessons learned after 1678 procedures"],"prefix":"10.1002","volume":"50","author":[{"given":"C.","family":"Zwiers","sequence":"first","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. T. M.","family":"Lindenburg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. J.","family":"Klumper","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"de Haas","sequence":"additional","affiliation":[{"name":"Department of Red Blood Cell Serology, Sanquin Diagnostics Amsterdam The Netherlands"},{"name":"Department of Immunohematology and Blood Transfusion Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Oepkes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. L.","family":"Van Kamp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(81)91549-X"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.1990.tb00855.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/j.0001-6349.2004.00394.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(96)00113-5"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.06.063"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000322919"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000328683"},{"key":"e_1_2_6_9_1","first-page":"129","article-title":"Intrauterine transfusion for fetal anemia due to red blood cell alloimmunization: 14 years experience in Leuven","volume":"7","author":"Pasman SA","year":"2015","journal-title":"Facts Views Vis Obgyn"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7696"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318235e3bb"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000073145"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12063"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.112970"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200001063420102"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052855"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.01.059"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12590"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.116690"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4152"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12265"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2007.01625.x"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2008.01742.x"},{"key":"e_1_2_6_24_1","first-page":"47","article-title":"Fetal blood sampling from the intrahepatic vein: analysis of safety and clinical experience with 214 procedures","volume":"76","author":"Nicolini U","year":"1990","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000091355"}],"container-title":["Ultrasound in Obstetrics & Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.17319","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.17319","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.17319","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T10:40:11Z","timestamp":1696502411000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.17319"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1002\/uog.17319"],"URL":"https:\/\/doi.org\/10.1002\/uog.17319","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8]]},"assertion":[{"value":"2016-04-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-09-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-08-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}