Fetal intrauterine transfusion

What is fetal intrauterine transfusion?

This procedure replenishes a baby’s red blood cells when he or she has severe anemia, similar to a transfusion an adult with critically low blood might receive. It might be recommended if your baby’s red blood cell count dips too low as a result of Rh incompatibility (when the mother has Rh-negative blood and the baby has Rh-positive blood) or some viral infections, such as parvovirus B19. Fetal blood transfusions can prevent a baby’s anemia from progressing into hydrops, a life-threatening condition. This procedure has been used to treat fetal anemia for decades and has a strong track record of success.

The mother is given local anesthesia for this procedure. Under ultrasound guidance, the maternal fetal medicine specialist inserts a needle into the mother’s abdomen and then into the umbilical cord vein. The surgeon will first take a sample of the baby’s blood for testing and then transfer red blood cells of a compatible blood type into the umbilical cord, where it is absorbed by the baby. If the umbilical cord can’t be accessed, the infusion might be given directly into the baby’s abdomen. The mother and baby receive antibiotics to prevent infection. The procedure may need to be repeated within the next 2-3 days and then 2-3 weeks afterward.

Candidates for fetal intrauterine transfusion

If your baby’s ultrasound reveals findings that are suspicious for low red blood cell count, your doctor may recommend fetal intrauterine transfusion.

• For safety’s sake, patients must meet the following criteria:
• There must be a potential maternal cause for anemia and ultrasound findings consistent with anemia.
• The transfusions are generally done between 18-35 weeks gestation.
• The baby must not have a genetic problem or any other major birth defect.

While fetal intrauterine transfusion is generally considered safe and beneficial for babies with anemia, in rare cases this procedure can lead to serious complications. The specialists at the Fetal Concerns Center will help you decide whether a fetal intrauterine transfusion is the right option for you and your baby.

How does fetal intrauterine transfusion affect my baby?

Replenishing critically low red blood cell counts can ease the stress on a baby’s body and prevent heart failure. It also reduces the chances of premature labor, allowing more time for your baby to develop in the womb.

How does fetal intrauterine transfusion affect the pregnancy?

Your pregnancy will be closely followed to monitor for signs of hydrops or heart failure. You might need to deliver early at the Froedtert & the Medical College of Wisconsin Birth Center, and your baby may require another blood transfusion immediately after birth.

What about after the fetal intrauterine transfusion?

You should be able to go home that same day. Repeated transfusions will likely be required every few weeks during the rest of your pregnancy and during your baby’s first six months of life. If your baby requires additional support after birth, he or she will receive top-notch care in Children’s Wisconsin’s Level IV Neonatal Intensive Care Unit, which is ranked as one of the best in the nation.

Will I be able to help care for my baby?

Absolutely. Our recently expanded and redesigned NICU was created to promote family bonding, with private rooms where parents can stay with their baby 24/7, and other special features for families’ comfort. Our on-call lactation specialists can help you successfully breastfeed and pump and store breast milk when direct breastfeeding isn’t an option.

When can my baby go home?

Your baby will be discharged from the hospital once he or she is breathing independently, eating well and gaining weight. That may take several weeks. Premature babies will likely require a longer NICU stay.

What’s my baby’s long-term prognosis?

Although outcomes depend on the severity of your baby’s condition, babies who undergo this procedure generally do very well. Babies who have not yet developed hydrops have survival rates greater than 90 percent, and even the majority of babies with hydrops survive after fetal intrauterine transfusion.

What about future pregnancies?