Fetal Blood Transfusion
(Intrauterine Transfusion; IUT; Intraperitoneal Transfusion; IPT)
by Suzanne Cote
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:
Reasons for Procedure TOP
A transfusion is needed when the fetus's blood count falls too low. Severe anemia in a fetus can cause death. Anemia can be caused by:
The goals of fetal blood transfusions are to:
Possible Complications TOP
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems like:
What to Expect TOP
Prior to Procedure
The doctor may do tests to see if the fetus has severe anemia or fetal hydrops.
The doctor may need to examine body fluids. This can be done with:
Your doctor may need pictures of your abdomen. This can be done with ultrasound.
If the fetus has hydrops, the blood transfusion will be done right away.
Before the transfusion, you may be given:
Local anesthesia numbs a small area of your abdomen.
Description of the Procedure TOP
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:
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.
How Long Will It Take? TOP
A 10 ml IVT transfusion will take 1-2 minutes. Usually, between 30-200 ml is transfused during a single procedure.
How Much Will It Hurt? TOP
You will feel pain and cramping where the doctor inserts the needle. If you are close to delivering the fetus or if the procedure is long, the uterus can be sore.
Average Hospital Stay TOP
This procedure is done in a hospital setting. You will be able to go home after the transfusion. If complications occur, you may need to have a cesarean section.
Post-procedure Care TOP
The doctor may give you:
Be sure to follow your doctor’s instructions.
After your baby has been delivered, the baby will need to have follow-up blood tests. The doctor will closely monitor the baby for:
Call Your Doctor TOP
Call your doctor if any of the following occurs:
Know the signs of early labor:
If you think you have an emergency, call for medical help right away.
The American Congress of Obstetricians and Gynecologists
American Pregnancy Association
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
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: http://www.america.... 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. 2005;192:171-177.
Last reviewed June 2013 by Andrea Chisholm, MD; Brian Randall, MD
Last Updated: 5/11/2013