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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, Ivica

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Volume 41, Issue 1


Therapeutic management of fetal anemia: review of standard practice and alternative treatment options

Nikos Papantoniou
  • First Department of Obstetrics and Gynecology, Alexandra Hospital, University of Athens, Athens, Greece
  • Other articles by this author:
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/ Stavros Sifakis / Aris Antsaklis
  • Corresponding author
  • First Department of Obstetrics and Gynecology, Alexandra Hospital, University of Athens, Athens, Greece
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Published Online: 2012-07-14 | DOI: https://doi.org/10.1515/jpm-2012-0093


Fetal anemia, mainly due to red cell alloimmunization, is still a significant cause of fetal and neonatal mortality and morbidity. The focus of current clinical research has shifted from an invasive approach to non-invasive management and treatment of affected pregnancies, and the progress in this field is associated with a major improvement in perinatal outcome. During the last 50 years, intrauterine red cells transfusion (IUT), first via the intraperitoneal route and later directly to fetal circulation, is the standard practice in most centers, with survival rates that exceed 90%, particularly if anemia is diagnosed early and treated in a timely manner. In addition, plasmapheresis and intravenous administration of high-dose immunoglobulin have been implicated in the treatment of pregnancies complicated with early-onset severe red cell alloimmunization, alone or in combination with IUTs before the 20th week of pregnancy, but there are still issues to be clarified further. This review article aims to provide an overview of the current standard therapeutic management and alternative treatment modalities in pregnancies complicated by fetal anemia.

Keywords: Fetal anemia; intrauterine red cells transfusion; intravenous immune globulin; plasmapheresis; red cell alloimmunization

About the article

Corresponding author: Prof. Aris Antsaklis, MD, PhD, FRCOG, Head and Chairman First Department of Obstetrics and Gynecology “Alexandra” Hospital, University of Athens 80 Vas. Sofias Av. Athens 11528 Greece Tel./Fax: +30 2103381791

Received: 2012-05-01

Accepted: 2012-05-29

Published Online: 2012-07-14

Published in Print: 2013-01-01

Citation Information: Journal of Perinatal Medicine, Volume 41, Issue 1, Pages 71–82, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2012-0093.

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