A transfusion is giving healthy blood or blood products from a donor. In this case, red blood cells are given to an unborn baby (fetus).
There are two types of fetal blood transfusions:
- Intravascular (IVT)—blood is transfused to the umbilical cord
- Intraperitoneal (IPT)—blood is transfused to the fetus’s belly (less common)
Reasons for Procedure
A transfusion is needed when the fetus has severe anemia. Anemia is a low level of red blood cells. Severe anemia in a fetus can cause death. Anemia can be caused by:
- Rh incompatibility—proteins in the mother's blood destroy blood cells in the fetus.
- Parvovirus B19 infection—a viral infection in the mother.
Anemia can cause a problem called hydrops. Hydrops is severe, life-threatening swelling in the fetus. A fetal blood transfusion is done to:
- Prevent or treat fetal hydrops
- Continue the pregnancy
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
What to Expect
Prior to Procedure
The care team may meet with you to talk about:
- Whether you will need a ride to or from the procedure
- Tests that may need to be done before the procedure
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Before the transfusion, you may be given:
- Pain medicine
- Medicine to help you relax
Medicine will be used to numb a small area of the belly.
Description of the Procedure
With IVT, medicine may be used to keep the fetus still for a short time. This will lower the risk of injury to the fetus. During both IVT and IPT, the doctor will watch the fetus with an ultrasound.
A needle will be inserted into the belly. The needle will be passed through the 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.
Transfusions may need to be repeated every 2 to 4 weeks until it is safe to deliver.
How Long Will It Take?
About 1 to 2 hours
Will It Hurt?
There will be some pain and cramping where the needle is inserted. The uterus may feel sore.
Average Hospital Stay
Some people go home the same day. Others may need to stay longer.
At the Care Center
The staff may give you:
- Pain medicine
- Antibiotics to prevent infection
- Medicine to prevent contractions or labor
It may take a few hours to feel the baby move again—if the baby was given medicine.
Call Your Doctor
Call your doctor if you have:
- Signs of infection, such as fever or chills
- Excess bleeding, redness, swelling, or discharge from the insertion site
- Pain you cannot control with the medicine
- Problems feeling the baby moving
Know the signs of early labor:
- A slow leak or sudden gush of fluid from the vagina
- Belly tightening
- Back pain that comes and goes
- Bleeding from the vagina
If you think you have an emergency, call for medical help right away.
American Pregnancy Association http://www.americanpregnancy.org
The American College of Obstetricians and Gynecologists http://www.acog.org
The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org
Women's Health Matters http://www.womenshealthmatters.ca
Abbasi N, Johnson JA, et al. Fetal anemia. Ultrasound Obstet Gynecol. 2017;50(2):145-153.
Hemolytic disease of the fetus and newborn (HDFN). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hemolytic-disease-of-the-fetus-and-newborn-hdfn. Accessed July 30, 2021.
Rhesus disease. National Health Services website. Available at: https://www.nhs.uk/conditions/rhesus-disease/treatment/. Accessed July 30, 2021.
Rh factor. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancycomplications/rhfactor.html. Accessed July 30, 2021.
- Reviewer: Daniel A. Ostrovsky, MD
- Review Date: 07/2021
- Update Date: 07/30/2021