A transfusion is giving healthy blood or blood products from a donor. In this case it is red blood cells that are given to a fetus.
There are 2 types of fetal blood transfusions:
A transfusion is needed when a fetus has severe anemia. Anemia is a low level of red blood cells. These cells are needed to carry oxygen throughout the body. Severe anemia in a fetus can cause death. Anemia can be caused by:
The goals of fetal blood transfusions are to:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems like:
Tests that were already done will be reviewed.
Your belly and womb may need to be viewed. This can be done with ultrasound.
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If the fetus has hydrops, the blood transfusion will be done right away.
Before the transfusion, you may be given:
Medicine will be used to numb a small area of your belly.
With IVT, medicine may be used to keep the fetus still for a short time. This will decrease the risk of injury to the fetus. During both IVT and IPT, the doctor will keep an eye on the fetus with an ultrasound. The ultrasound will:
A needle will be inserted into your belly. The needle will be passed through your uterus and into the umbilical cord. (With IPT, it will pass in the fetal belly instead of cord.) The donor blood will be passed to the fetus.
A final blood sample will be taken. It will show the change to the fetus's blood. The doctor will use this to know if the transfusion was enough and when the next one should be.
The transfusions may need to be repeated every 2 to 4 weeks until it is safe to deliver.
It can take 1 to 2 hours for the entire process.
You will feel pain and cramping where the doctor inserts the needle. The uterus may feel sore. This is more likely if you are close to delivering.
This procedure is done in a hospital setting. You will be able to go home after the transfusion.
You may be given:
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 if any of the following occur:
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
American College of Obstetricians and Gynecologists. ACOG practice bulletin No. 75: Management of isoimmunization in pregnancy. Obstet Gynecol. No. 75. 2006 Aug;108(2):457-464.
Rhesus disease. National Health Services website. Available at: https://www.nhs.uk/conditions/rhesus-disease/treatment/. Updated November 6, 2018. Accessed February 12, 2019.
Rh factor. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancycomplications/rhfactor.html. Updated March 2, 2017. Accessed February 12, 2019.
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 February 2019 by Daniel A. Ostrovsky, MD Last Updated: 2/12/2019