Non-Invasive Diagnosis and Monitoring for Fetal Anemia

Transcript

• 00:13The red blood cells carry
• 00:14the oxygen to the tissue.
• 00:16And as they unload, they
• 00:18have to go and just
• 00:19reload and come back, reload
• 00:21and come back. However, if
• 00:23the number of the red
• 00:24blood cells are scarce or
• 00:26low, then it would be
• 00:27an anemia. Then the demand
• 00:29of oxygen might not be
• 00:30met.
• 00:31In the fetal life, that
• 00:33oxygenation happens at the level
• 00:35of placenta.
• 00:45The fetal anemia can be
• 00:47caused by multiple reasons. If
• 00:49there is
• 00:50an incompatibility
• 00:52between the pregnant person's blood
• 00:55type and the fetuses
• 00:57blood type,
• 00:59inevitably
• 01:00would lead to an immune
• 01:02response to develop within the
• 01:04pregnant person.
• 01:06And those antibodies
• 01:07are able to be transferred
• 01:09through the placenta to go
• 01:11to the fetus
• 01:12and destroy those red blood
• 01:15cells.
• 01:16In order to compensate
• 01:18for the need of oxygen,
• 01:20the fetal heart starts working
• 01:22faster
• 01:23and harder.
• 01:24And at some point, the
• 01:26heart would get tired, then
• 01:28it would not pump
• 01:30and the blood would back
• 01:31up, then that would be
• 01:33just before a fetal demise.
• 01:44In the past, the diagnosis
• 01:45was done invasively.
• 01:47However, Yale showed that we
• 01:50could predict the level of
• 01:51anemia through the speed of
• 01:53the blood in the brain,
• 01:54which is called middle cerebral
• 01:56artery Doppler.
• 01:58And today, we monitor our
• 02:00patients with that.
• 02:05If we see that the
• 02:06anemia is in the
• 02:08severe range,
• 02:09then we can
• 02:11do blood transfusion.
• 02:13If we suspect anemia very
• 02:15early in pregnancy, we can
• 02:16give the blood into the
• 02:18abdominal cavity of the baby,
• 02:20where it gets slowly absorbed
• 02:23into the fetal system.
• 02:25However, later, about after sixteen,
• 02:27seventeen weeks, the size of
• 02:28the cord gets large enough
• 02:30that we can insert a
• 02:32needle
• 02:33reliably and repeatedly,
• 02:35and, sample and deliver the
• 02:37blood as much as it
• 02:39is needed.
• 02:41After birth, the anemia
• 02:43generally resolves.
• 02:48What we believe, and I
• 02:51practice,
• 02:52is the human touch.
• 02:55We do not
• 02:56leave our patients alone. We
• 02:59spend
• 03:00time and effort to be
• 03:02with them throughout their journey.
• 03:05These procedures are available
• 03:07through multiple
• 03:08centers,
• 03:09But what is really different
• 03:11is the personal
• 03:12touch being next to the
• 03:14patient,
• 03:15being with them through the
• 03:17diagnosis
• 03:18and through the prenatal care
• 03:20and the delivery and the
• 03:22transitions.
• 03:24Treatment is the easiest part.
• 03:26The feeling that they are
• 03:27not alone is the most
• 03:28important thing.