Fetal Blood Transfusion
(Intrauterine Transfusion; IUT; Intraperitoneal Transfusion; IPT)
- 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
- Rh incompatibility —the mother and baby have a different type of blood, and mother’s antibodies to fetal blood cells lyse (destroy) fetal blood cells.
- Parvovirus B19 infection —a viral infection in the mother
- Twin-to-twin transfusion syndrome—can occur in monochorionic (developing in one chorionic sac) twin pregnancies
- 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 the pregnancy so the baby can be born close to term
- Need for Cesarean section (C-section) due to fetal distress after the procedure
- Premature rupture of membranes and/or premature labor
- Abdominal bruising or soreness
- Bleeding, cramping, or leaking fluid from vagina
- Injury to the fetus
- Giving too much blood
- Fetal bleeding
- Causing your water to break
- Graft versus host disease in the fetus (a rare condition in which the donor’s blood cells attack the baby's blood cells)
What to Expect
Prior to Procedure
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- Pain medicine
- Muscle relaxant through an injection or an IV
Description of the Procedure
- 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
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- Antibiotics to prevent infection
- Medicine to prevent contractions or labor
- Liver damage
- Congestive heart failure
- Respiratory failure
- Other complications if the baby is premature
Call Your Doctor
- Signs of infection, including fever or chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the needle insertion site
- You are not feeling your baby moving normally
- Water breaks (a sign of labor)
Other signs of early labor:
- Uterine contractions
- Back pain that comes and goes
- Vaginal bleeding
The American Congress of Obstetricians and Gynecologists http://www.acog.org/For%5FPatients
American Pregnancy Association http://www.americanpregnancy.org/
The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org
Women's Health Matters http://www.womenshealthmatters.ca/
Anderson K, Ness P, eds. Scientific Basis of Transfusion Medicine: Implications for Clinical Practice . 2nd ed. Philadelphia, PA: WB Saunders Company; 2000.
Behrman R, Kliegman R, Jenson H, eds. Nelson Textbook of Pediatrics . 17th ed. Philadelphia, PA: Elsevier; 2004.
Creasy R, Resnik R, eds. Maternal-Fetal Medicine . 4th ed. Philadelphia, PA: WB Saunders Company; 1999.
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.
Harman C, ed. Invasive Fetal Testing and Treatment . Boston, MA: Blackwell Scientific Publications; 1995.
Kenner C, Wright Lott J, eds. Comprehensive Neonatal Nursing: A Physiologic Perspective . 3rd ed. Philadelphia, PA: Saunders; 2003.
Management of Isoimmunization in Pregnancy. ACOG Educational Bulletin . No. 227. August 1996.
Mintz P, ed. Transfusion Therapy: Clinical Principles and Practice . Baltimore, MD: AABB Press; 1999.
Nelson N, ed. Current Therapy in Neonatal-Perinatal Medicine 2 . Philadelphia, PA: BC Decker Inc.; 1990.
Petz L, Kleinman S, Swisher S, et al, eds. Clinical Practice of Transfusion Medicine . 3rd ed. NY: Churchill Livingstone; 1996.
Reece E, Hobbins J, eds. Medicine of the Fetus and Mother . 2nd ed. Philadelphia, PA: Lippincott-Raven; 1999.
Rh factor. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancycomplications/rhfactor.html . Updated April 2006. Accessed December 20, 2012.
van Kamp I, Klumper F, Oepkes D, et al. Complications of intrauterine intravascular transfusion of fetal anemia due to maternal red-cell alloimmunization. Am J Obstet Gynecol . 2005;192:171-177.
- Reviewer: Andrea Chisholm, MD
- Review Date: 11/2012 -
- Update Date: 11/26/2012 -