OP22.11: Early intra‐uterine transfusions (IUT) in severe red blood cell (RBC) alloimmunization
Bibliographic record
Abstract
To determine the perinatal outcome in pregnancies with early severe RBC alloimmunization. Retrospective analysis of 25 patients requiring their first IUT < 22 weeks gestation. Timing of the first IUT was based either on Doppler evaluation of the middle cerebral artery peak systolic velocity (MCA-PSV) or the development of ascites. Forty two percent had had a previous intrauterine fetal death due to RBC alloimmunization. The offending antibodies were D (13), Kell (3), mixed (9), and titres before first IUT ranged from 1 : 128–1 : 8192. All fetuses were severely anemic prior to the first IUT with a mean hemoglobin (Hb) of 37 ± 23 (3–81) g/L. Mean gestation at first IUT was 20.1 ± 1.7 (16–22) weeks, and 1–9 transfusions were needed during pregnancy. Transfusion was via the intra-hepatic vein (13), umbilical vein (7), umbilical artery (2), intra-cardiac (2) or intra-peritoneal (1) routes. Nine hydropic fetuses had lower Hb's (22.3 ± 20.8 g/L) compared to non-hydropic fetuses (46 ± 21.8 g/L). However, 8 non-hydropic fetuses had a Hb < 50 g/L prior to the first IUT. Overall perinatal survival rate was 73% and did not differ between hydropic and non-hydropic fetuses. Mean gestation at delivery, after exclusion of 6 intra-uterine fetal deaths was 35.8 (27.8–38.4) weeks. In early severe RBC alloimmunization, fetuses can be severely anemic without hydrops, and prognosis cannot be predicted by the presence or absence of hydrops. Early IUT followed by serial transfusions results in a perinatal survival of 73%.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".