Fetal Blood Transfusion
(Intrauterine Transfusion; IUT; Intraperitoneal Transfusion; IPT)
DefinitionThis procedure is done when a fetus suffers from severe anemia . Anemia is a lack of red blood cells. A transfusion means giving the fetus red blood cells from a donor. There are two types of fetal blood transfusions:
- Intravascular transfusion (IVT)—done through the mother’s abdomen into the fetus’s umbilical cord
- Intraperitoneal transfusion (IPT)—done through the mother’s abdomen and uterus into the fetus’s abdomen; usually only done if IVT is impossible to do because of the position of the fetus and the umbilical cord
Reasons for ProcedureA transfusion is needed when the fetus's blood count falls too low. Severe anemia in a fetus can cause death. Anemia can be caused by:
- Rh incompatibility —the mother and fetus have a different type of blood, and mother’s antibodies to fetal blood cells destroy fetal blood cells
- Parvovirus B19 infection —a viral infection in the mother
- Twin-to-twin transfusion syndrome—can occur in twin pregnancies where development is in one chorionic sac
- Prevent or treat fetal hydrops before delivery—Hydrops is caused by severe anemia in the fetus, which develops into heart failure. This leads to fluid collecting in the skin, lungs, abdomen, or around the heart.
- Continue the pregnancy so the fetus can be born close to term
Possible ComplicationsProblems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems like:
- Need for cesarean section because of 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
- A rare condition in which the donor’s blood cells attack the fetus's blood cells
What to Expect
Prior to ProcedureThe doctor may do tests to see if the fetus has severe anemia or fetal hydrops.The doctor may need to examine body fluids. This can be done with:
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- Pain medication
- Medication to help you relax
AnesthesiaLocal anesthesia numbs a small area of your abdomen.
Description of the ProcedureWith IVT, the fetus will be paralyzed for a short time. This is to allow access to fetal blood vessels and to reduce injury to the fetus. During both IVT and IPT, the doctor will monitor the fetus with an ultrasound scan. The ultrasound will:
- 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?A 10 ml IVT transfusion will take 1-2 minutes. Usually, between 30-200 ml is transfused during a single procedure.
How Much Will It Hurt?You will feel pain and cramping where the doctor inserts the needle. If you are close to delivering the fetus or if the procedure is long, the uterus can be sore.
Average Hospital StayThis procedure is done in a hospital setting. You will be able to go home after the transfusion. If complications occur, you may need to have a cesarean section.
Post-procedure CareThe doctor may give you:
- Antibiotics to prevent infection
- Medication to prevent contractions or labor
- Liver damage
- Heart failure
- Respiratory failure
- Other complications if the baby is premature
Call Your DoctorCall your doctor if any of the following occurs:
- 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
- Uterine contractions
- Back pain that comes and goes
- Vaginal bleeding
The American Congress of Obstetricians and Gynecologists
American Pregnancy Association
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
Gibson BE, Todd A, 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.
Management of Isoimmunization in Pregnancy. ACOG Educational Bulletin . No. 227. August 1996.
Rh factor. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancycomplications/rhfactor.html. Updated April 2006. Accessed June 10, 2013.
van Kamp I, Klumper F, 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: 05/2014
- Update Date: 05/28/2014