SENSORINEURAL OUTCOME AT 2 YEARS FOR SURVIVORS OF ERYTHROBLASTOSIS TREATED WITH FETAL INTRAVASCULAR TRANSFUSIONS

Objective: To determine the sensorineural outcome at 2 years of age in a complete cohort of survivors of fetal intravascular transfusions. M ethods: From March 1984 to May 1990, 38 of 52 consecutive fetuses (73% ) suffering from severe erythroblastosis survived attempted intravascu lar transfusions at the Royal Women's Hospital, Melbourne. At 2 years of age, corrected for prematurity where appropriate, the survivors had a psychological assessment, including the mental developmental index of the Bayley scales, and a standardized neurodevelopmental examinatio n. Results: Only one transfused child had a severe sensorineural disab ility, with severe developmental delay and multiple minor motor seizur es. Another child was moderately disabled with spastic hemiplegia. In neither case were complications of an intravascular transfusion the li kely explanation for the disability. Only one other child had a mental developmental index in the suspect range. The remaining 35 children ( 92.1%) had no sensorineural disability. The overall rate of sensorineu ral impairments and disabilities was lower in the group transfused tha n in previous reports of survivors of intraperitoneal transfusions. Th e mean mental developmental index was significantly higher in the tran sfused group than in a control group of normal birth weight children. Conclusion: Children who survive fetal intravascular transfusions comp are favorably not only with other high-risk survivors, but also with l ow-risk children.