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This procedure is done when a fetus suffers from severe
anemia. Anemia is a lack of red blood cells. A transfusion means giving the fetus red blood cells from a donor.
There are two types of fetal blood transfusions:
Intravascular transfusion (IVT)—done through the mother’s abdomen into the fetus’s umbilical cord
Intraperitoneal transfusion (IPT)—done through the mother’s abdomen and uterus into the fetus’s abdomen; usually only done if IVT is impossible to do because of the position of the fetus and the umbilical cord
Twin-to-twin transfusion syndrome—can occur in twin pregnancies where development is in one chorionic sac
The goals of fetal blood transfusions are
Prevent or treat fetal hydrops before delivery—Hydrops is caused by severe anemia in the fetus, which develops into heart failure. This leads to fluid collecting in the skin, lungs, abdomen, or around the heart.
Continue the pregnancy so the fetus can be born close to term
With IVT, the fetus will be paralyzed for a short time. This is to allow access to fetal blood vessels and to reduce injury to the fetus. During both IVT and IPT, the doctor will monitor the fetus with an ultrasound scan. The ultrasound will:
Show the position of the fetus
Guide the placement of the needle through the amniotic sac and into the vessel in the umbilical cord
Record the fetal heart rate
The doctor will insert a needle into your abdomen. Using ultrasound, the doctor will make sure the needle is placed correctly. The needle will go through your abdomen and be inserted into the umbilical cord (IUT) or into the fetal abdomen (IPT). Blood will be transfused to the fetus.
Before the needle is removed, the doctor will take a final blood sample. This is to determine the fetus's blood level. The doctor will find out whether the transfusion was enough and when the next one should be.
The transfusions may need to be repeated every 2-4 weeks until your doctor decides that it is safe to deliver the fetus.
Gibson BE, Todd A, et al. British Committee for Standards in Haematology Transfusion Task Force: Writing group. Transfusion guidelines for neonates and older children.
Br J Haematol
. 2004; 124: 433-453.
Management of Isoimmunization in Pregnancy.
ACOG Educational Bulletin
No. 227. August 1996.
Rh factor. American Pregnancy Association website. Available at: ...(Click grey area to select URL) Updated April 2006. Accessed June 10, 2013.
van Kamp I, Klumper F, et al. Complications of intrauterine intravascular transfusion of fetal anemia due to maternal red-cell alloimmunization.
Am J Obstet Gynecol
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