Fetal Anemia / Intrauterine Blood Transfusion
Fetal anemia is a decrease in fetal red blood cells. This occurs when red blood cells are not being produced or are being destroyed faster than they are being made. Fetal anemia is most commonly caused by an incompatibility between the mother and baby's red blood cells. Though rare, parvo virus is another cause of fetal anemia. Fetuses with severe anemia can go on to have congestive heart failure and hydrops which can lead to death.
If anemia is diagnosed or suspected, your baby will be monitored frequently by measuring blood flow through one of the vessels in the brain. This is done by ultrasound. Depending on the results, your doctor may recommend an intrauterine blood transfusion.
Intrauterine Transfusions
Intrauterine transfusions are blood transfusions that are used to replace fetal red blood cells. Transfusions can be done in the fetal abdomen, but are more typically done in the umbilical vein. They are usually done every 1-4 weeks until delivery.
If your baby needs a transfusion, it will be done in the hospital and may involve staying overnight. You will be given an IV (intraveneous) in order to give antibiotics as well as mild sedation during the procedure. The procedure will be done in the operating room to enable the doctors to have adequate room and maintain sterility. The abdomen will be cleaned with an antiseptic solution. Using ultrasound guidance, a small needle is placed into the mother's abdomen and into the uterus. Your baby may receive medication so that it does not move during the procedure. This medication usually wears off within an hour or two. Once the needle is in the uterus, the doctor will carefully guide the needle into the fetal abdomen or umbilical cord so the transfusion may begin.
Following the transfusion, you will be taken back to Labor and Delivery and placed on fetal monitors, allowing the staff to watch for contractions and your baby's heartbeat. You may receive medications to stop contractions if necessary.
Fetal survival after an intrauterine transfusion is dependant on the severity of the fetal illness. There is a 90% or more survival rate for fetuses that do not have hydrops and approximately 75% survival rate for those that do have hydrops.
