Intrauterine transfusion is a procedure in which red blood cells from a donor are injected into the fetus.
Intrauterine transfusion may be recommended when a fetus has anemia (low red blood cell count). Fetal anemia may be caused by:
• Rh incompatibility: When the mother and fetus have different blood types, the antibodies in the mother’s blood may destroy blood cells in the fetus
• Some viral infections e.g. Parvovirus B19 viral infection in the mother
• Twin to twin transfusion syndrome
Goals of intrauterine transfusion are to prevent or treat fetal heart failure (hydrops), which can be caused by anemia, and to allow the pregnancy to continue so the baby can be more developed when it is born.
About the procedure
There are two methods to perform fetal blood transfusions. In both, a needle is inserted into the mother’s abdomen.
• Intravascular transfusion (IVT): blood is transfused into the umbilical cord
• Intraperitoneal transfusion (IPT): blood is transfused into the fetus’ abdomen. This is not as common.
Intrauterine transfusion is performed in the hospital, usually on an outpatient basis. The mother is given antibiotics, local anesthesia and IV sedation, which also sedates the fetus. The fetus may be given additional medication to stop movement. Using ultrasound to determine the position of the fetus and placenta, the surgeon inserts a needle into the mother’s abdomen and then into the umbilical cord vein or the fetus’ abdomen. Red blood cells that are compatible with the fetus’ blood type are passed through the needle into the fetus. The mother will probably not have to spend the night in the hospital, but the doctor may prescribe antibiotics and medication to prevent labor. Fetal transfusions may need to be repeated every few weeks until the fetus is ready to be born.
The chance of problems is rare, but there are risks in every procedure. In intrauterine transfusion, these may include:
• Fetal distress and the need for cesarean section delivery
• Premature labor
• Cramping or vaginal bleeding or discharge
• Infection