Preterm labor.
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Adrenal Cortex Hormones↗
Biomedical subjects
I Wilkins
Publications and source records attributed to I Wilkins.
Amnionitis and life-threatening respiratory distress after percutaneous umbilical blood sampling.
Although amnionitis secondary to percutaneous umbilical blood sampling is extremely uncommon, a high index of suspicion should be maintained and a full evaluation should be initiated if nonspecific signs of infection appear within 2 weeks after the procedure is performed. In this case life-threatening adult respiratory distress syndrome was a sequela of this complication.
Adult↗
The in utero diagnosis and management of alloimmune thrombocytopenia.
A case is presented in which percutaneous umbilical sampling (PUBS) was utilized in the second and third trimesters for the diagnosis and management of a pregnancy at risk for neonatal alloimmune thrombocytopenia (NAIT).
Adult↗
The role of sonography in assessing severity of fetal anemia in Rh- and Kell-isoimmunized pregnancies.
Fetal hematocrit values of blood obtained by percutaneous umbilical blood sampling were correlated with ultrasound findings in 35 samples from 15 pregnancies undergoing evaluation for Rh or Kell sensitization. Intravascular fetal transfusion was performed after a low hematocrit was obtained on 29 of 35 occasions. All fetuses with sonographic evidence of hydrops had a hematocrit of 15% or less, although three fetuses with hematocrits below 15% showed no signs of hydrops. In patients followed with serial sonography, hydramnios was noted as the earliest sonographic abnormality in six of nine pregnancies. All six fetuses were anemic (hematocrit 14-26%) and required transfusion. However, in three pregnancies where the fetus was anemic (hematocrit 22%), there was no hydramnios or other sonographic abnormality. Increased placental thickness was observed in association with fetal hydrops and a hematocrit below 15% in four cases, as well as in three other cases with fetal hematocrit between 16-29% but no fetal hydrops. Measurements of umbilical vein diameter provided no useful information because no increase was observed in these measurements, even in pregnancies with advanced fetal disease evidenced by hydrops.
Anemia↗
Technical aspects of intravascular intrauterine transfusions: lessons learned from thirty-three procedures.
Our technique for performing intravascular transfusions is described and four failed attempts are presented. The appropriate choice of needle, insertion site, and premedication are discussed. A rationale for intravenous fetal muscle blockade in selected cases is presented and a transfusion setup designed to minimize movement of the needle hub is described. Finally, the judicious use of intraperitoneal transfusions in some cases is suggested.
Blood Transfusion, Intrauterine↗
Intrauterine intravascular transfusions for severe red blood cell isoimmunization: ultrasound-guided percutaneous approach.
Eight pregnancies with severe red blood cell isoimmunization were managed with use of an intravascular approach for intrauterine transfusions. Fetoscopy was not employed, and the procedures were performed percutaneously under direct ultrasound visualization. A total of 16 of 18 attempted transfusions were successfully performed, with four fetuses requiring more than one transfusion. Technical aspects of the procedure as well as its indications, advantages, and drawbacks are discussed.
Adult↗
Intravascular transfusion in utero: the percutaneous approach.
A severely Rh-isoimmunized pregnancy is described in which an intrauterine transfusion of blood was given by the intravascular route directly into an umbilical vessel. Fetoscopy was not used, and the procedure was performed percutaneously under direct ultrasound visualization.
Adult↗