{"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":1792534011589,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,4,2]],"date-time":"2013-04-02T00:00:00Z","timestamp":1364860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2013,6]]},"abstract":"\n Objectives<\/jats:title>\n \n To evaluate and compare perinatal outcome after intrauterine transfusions (\n IUT<\/jats:styled-content>\n ) performed before and after 20\u00a0weeks of gestation. To analyse contributing factors.\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Retrospective analysis.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n The Dutch referral centre for fetal therapy.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n \n IUT<\/jats:styled-content>\n s for fetal alloimmune anaemia.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Fetuses were divided into two groups: fetuses requiring the first\n IUT<\/jats:styled-content>\n before 20\u00a0weeks of gestation (Group 1) and those in which the\n IUT<\/jats:styled-content>\n s started after 20\u00a0weeks (Group 2). The cause of perinatal loss was classified as procedure\u2010related (\n PR<\/jats:styled-content>\n ) or not procedure\u2010related (\n NPR<\/jats:styled-content>\n ). The cohort was divided into two periods to describe the change of perinatal loss over time.\n <\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n \n Perinatal loss of fetuses requiring the first\n IUT<\/jats:styled-content>\n before 20\u00a0weeks of gestation, compared with perinatal loss later in gestation.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 1422\n IUT<\/jats:styled-content>\n s were performed in 491 fetuses. Perinatal loss rate in Group 1 was higher (7\/29 24% versus 35\/462 8%,\n P<\/jats:italic>\n \u00a0=\u00a00.002). Especially\n NPR<\/jats:styled-content>\n was higher for\n IUT<\/jats:styled-content>\n s performed before 20\u00a0weeks (4\/37 11% versus 19\/1385 1%,\n P<\/jats:italic>\n \u00a0<\u00a00.001). Kell alloimmunisation was overrepresented in Group 1 (7\/29 24% versus 52\/462 11%,\n P<\/jats:italic>\n \u00a0=\u00a00.04). In a multivariate regression analysis, only hydrops was independently associated with perinatal loss (\n P<\/jats:italic>\n \u00a0=\u00a00.001). In recent years, a decline in total perinatal loss was found (36\/224 16% versus 6\/267 2%,\n P<\/jats:italic>\n \u00a0<\u00a00.001), but perinatal loss in Group 1 did not decline (4\/224 1.8% versus 3\/267 1.1%,\n P<\/jats:italic>\n \u00a0=\u00a00.5).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Perinatal loss after\n IUT<\/jats:styled-content>\n performed before 20\u00a0weeks of gestation is increased compared with loss after\n IUT<\/jats:styled-content>\n performed later in gestation. In addition, we confirmed earlier observations that hydrops is a major contributor to adverse outcome. Early and timely detection and treatment may prevent hydrops and improve outcome.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.12063","type":"journal-article","created":{"date-parts":[[2013,4,2]],"date-time":"2013-04-02T10:31:57Z","timestamp":1364898717000},"page":"847-852","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":77,"title":["Increased perinatal loss after intrauterine transfusion for alloimmune anaemia before 20\u00a0weeks of gestation"],"prefix":"10.1111","volume":"120","author":[{"given":"ITM","family":"Lindenburg","sequence":"first","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"IL","family":"\u00a0van Kamp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EW","family":"\u00a0van Zwet","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JM","family":"Middeldorp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"FJCM","family":"Klumper","sequence":"additional","affiliation":[{"name":"Department of Obstetrics 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"}]}],"member":"311","published-online":{"date-parts":[[2013,4,2]]},"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":"10.1016\/j.ajog.2004.06.063"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31817d453c"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000328683"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(96)00113-5"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7696"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01353.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.116690"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199203000-00013"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/j.0001-6349.2004.00394.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(84)90683-5"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(88)91896-X"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(94)90477-4"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70425-8"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5365.1107"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0028-2243(89)90080-4"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000111599"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(70)92406-2"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.2920100410"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(85)92451-1"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198802253180816"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-199703000-00022"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpme.1997.25.1.85"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1423-0410.2001.00021.x"},{"key":"e_1_2_6_26_1","first-page":"e1","article-title":"Combined plasmapheresis and intravenous immune globulin for the treatment of severe maternal red cell alloimmunization","volume":"196","author":"Ruma SR","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_6_27_1","first-page":"e1","article-title":"Long\u2010term neurodevelopmental outcome after intrauterine transfusion for hemolytic disease of the fetus\/newborn; 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