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Lahey Health is now part of Beth Israel Lahey Health

by Cote S
(Intrauterine Transfusion; IUT; Intraperitoneal Transfusion; IPT)

Definition

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:

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

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Need for cesarean section—if the fetus has problems
  • Premature rupture of membranes and/or premature labor
  • Bleeding, cramping, or leaking fluid from vagina
  • Infection in the uterus or fetus
  • Injury to the fetus
  • Giving too much blood
  • The donor’s blood cells attack the fetus's blood cells—rare

What to Expect

Prior to Procedure

The care team may meet with you to talk about:

  • Anesthesia
  • Whether you will need a ride to or from the procedure
  • Tests that may need to be done before the procedure
Amniocentesis
Amniocentesis
Copyright © Nucleus Medical Media, Inc.

Before the transfusion, you may be given:

  • Pain medicine
  • Medicine to help you relax

Anesthesia

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.

Post-procedure Care

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.

RESOURCES

American Pregnancy Association  http://www.americanpregnancy.org 

The American College of Obstetricians and Gynecologists  http://www.acog.org 

CANADIAN RESOURCES

The Society of Obstetricians and Gynaecologists of Canada  http://www.sogc.org 

Women's Health Matters  http://www.womenshealthmatters.ca 

References

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.

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