Two or more determinations recommended for valid prognostication, since a single test result can be misleading.
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? OD450
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Action
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< 0.07
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continued observation, with vaginal delivery at or near term
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0.07 - 0.17
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delivery should be accomplished between the end of the 34th week and beginning of the 38th week
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> 0.17
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immediate therapy, either intrauterine exchange if under 34 weeks or premature delivery if over 34 weeks
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The first group had 100% survival, with some requiring intrauterine transfusion.
The second group showed about 75% survival with many infants requiring intrauterine transfusions. If sequential determinations of the ?OD450 are performed
(1) Those with the ? OD450 decreasing by at least 0.01 units per week had the lowest mortality (11%)
(2) Those with the ? OD450 increasing by at least 0.01 units per week had the highest mortality rate (64%)
(3) Those with the ?OD450 stable (not decreasing or increasing by more than 0.01 unit per week) had an intermediate mortality rate (31%)
The third group can be further subdivided into 3 groups (0.18 - 0.30, 0.31- 0.40, > 0.40) with increasing fetal mortality and need for intrauterine transfusion.
Limitation:
• The mortality rates observed today (almost 30 years later) would be decreased due to better intrauterine and neonatal management. However, the relative severity of the different groups are still pertinent.
