This procedure is done when a baby that is still in the womb suffers from severe
. Anemia is
a lack of red blood cells. When the baby's blood count falls too low, a transfusion is needed. A transfusion means giving the baby 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’ umbilical cord; more common procedure
Intraperitoneal transfusion (IPT)—done through the mother’s abdomen and uterus into the fetus’ abdomen; usually only done if IVT is impossible to do because of the position of the baby and the umbilical cord
Reasons for Procedure
Fetal blood transfusions are done because the baby in the womb is suffering from severe anemia and could die without this transfusion. Anemia can be caused by:
Prevent or treat fetal hydrops before delivery—Hydrops is caused by severe anemia in the fetus. The fetus develops heart failure. This leads to fluid collecting in the skin, lungs, abdomen, or around the heart.
Continue pregnancy so the baby can be born close to term
Possible complications for mother and fetus include:
If the fetus has hydrops, the blood transfusion will be done right away.
Before the transfusion, you may be given:
Muscle relaxant through an injection or an IV
Local anesthesia—numbs a small area of your abdomen
Description of the Procedure
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' blood level (called hematocrit). 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 baby.
How Long Will It Take?
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?
You will feel pain and cramping where the doctor inserts the needle. If you are close to delivering the baby or if the procedure is long, the uterus will be sore.
Average Hospital Stay
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 C-section.
The doctor may give you:
Antibiotics to prevent infection
Medicine to prevent contractions or labor
Be sure to follow your doctor’s instructions.
Once your baby has finally delivered, the baby will need to have follow-up blood tests. The doctor will closely monitor the baby for:
Gabbe S, Niebyl J, Simpson JL, eds.
Normal and Problem Pregnancies
. 4th ed. Oxford, UK: Churchill Livingstone, Inc; 2002.
Gibson BE, Todd A Roberts I, Pamphilon D, 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.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a