What you need to know about:

Intrauterine Fetal Blood Transfusion

Fast Fact

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Average Cost:
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Recovery Period:
1 to 3 hours
Permanence:
Repeat every 1 to 4 weeks as needed until fetus is delivered safely
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Doctors
Time it takes:
15-30 minutes
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Anesthetize:
Local anesthesia

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Overview of

Intrauterine Fetal Blood Transfusion

in Thailand

Intrauterine Fetal Blood Transfusion is a procedure in which the fetus receives red blood cells from a donor while still in utero (inside the uterus). This is commonly done when the fetus exhibits symptoms of anemia – a condition characterized by a low red blood cell count.  Red Blood Cells (RBC) carry oxygen and nutrients to different parts of the body. A low RBC count may suggest a decreased level of oxygen which may affect fetal development and cause strain to the fetus’ heart and lungs.

Fetal anemia may stem from Rh incompatibility, viral infections, or twin to twin transfusion syndrome. Rh factor is a protein that may or may not be present on the surface of red blood cells. When a Rh-negative mother carries a Rh-positive fetus, the mother’s immune system considers the baby’s blood as foreign. Therefore, the mother’s immune system destroys the baby’s RBCs, causing anemia. Intrauterine Fetal Blood Transfusion replaces the destroyed red blood cells with Rh compatible blood administered through the umbilical cord.

Goals of

Intrauterine Fetal Blood Transfusion

The goal of Intrauterine Fetal Blood Transfusion is to prevent or treat heart failure brought about by fetal anemia. The fetus is given transfusions every 1 to 4 weeks until it can be delivered safely. It aims to give the fetus the best chance of having a healthy life outside of the uterus.

Hydrops fetalis is the abnormal accumulation of fluids in at least 2 of the following compartments: abdomen, heart, lungs, and the skin. This condition is caused by severe anemia and may eventually develop into heart failure.

In this case, diligent pre-natal care is key. Fetal anemia may be suspected after organ swelling has been observed via ultrasound. Doppler ultrasound of the middle cerebral artery and Fetal Blood Sampling may confirm the diagnosis.

Price of

Intrauterine Fetal Blood Transfusion

Average Cost

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Price Range

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Pros and cons of

Intrauterine Fetal Blood Transfusion

Pros

Intrauterine Fetal Blood Transfusion significantly improves the fetus’ chance of survival. Studies have suggested that fetal survival rates are at 80.5-93.5% if blood transfusion is attempted. In addition, the odds remain the same if the transfusion is given before or after hydrops fetalis develops.

Cons

Intrauterine Fetal Blood Transfusion requires strict monitoring and management. In some cases, it may induce pre-term labor cause hemorrhage, amniotic fluid leakage, or even fetal death.

How it works:

Intrauterine Fetal Blood Transfusion

Once it has been determined that your baby will need blood transfusion, several things will begin to happen immediately. Remember, both the mother and the baby’s care and safety are of utmost importance.

A sedative is given to the mother to help her relax while local anesthesia is injected to the abdomen. An ultrasound machine is on standby to monitor the fetus and locate the blood vessels of the umbilical cord. A needle will be inserted into the cord to retrieve blood for a Complete Blood Count. This is needed to determine just how much blood is needed for the transfusion. In order to prevent complications, medication will be administered to slow fetal movements.  

Once the mother and the fetus are stable, the transfusion will commence. The process takes about 1-2 hours to complete during which both mother and fetus will be under observation. Blood will be drawn again after the procedure to aid in treatment planning.

Mothers describes the procedure as uncomfortable. If you begin to feel pain during the procedure, let your doctor know immediately so additional pain-relief medication can be given.

Preparation before

Intrauterine Fetal Blood Transfusion

Pre - treatment

Pre-natal laboratory work may include ultrasounds and testing blood from the umbilical cord. Once hydrops is confirmed, blood donation can be commenced. The donor’s blood is typed and cross-matched to determine if it is compatible with the fetus. Moreover, donors should be in good physical condition – no drugs and alcohol in the system. The donor should not be on blood thinners. But if it cannot be helped, these medications should be stopped at least 5 days before the procedure.

Recovery after

Intrauterine Fetal Blood Transfusion

Post - treatment

The entire procedure will last between 1 to 2 hours but you may be asked to stay in the hospital a bit longer to make sure you’re stable enough to go home. Antibiotics, pain relievers and muscle relaxants may be given to help prevent post-op complications. Your healthcare provider will explain what you need to watch out for at home.

Risks & side effects

Since this procedure involves two lives, it is considered to be a high-risk procedure. However, risk stratification will be done pre-procedure to mitigate any risks. In some cases, complications such as pre-mature labor, infection, or bleeding may also arise due to the procedure.

Once you get home from the hospital, its imperative that you observe for any untoward symptoms such as high fever, decreased fetal movement, or excessive vaginal bleeding. If you experience any of these, seek help immediately.

FAQs:

Intrauterine Fetal Blood Transfusion

What would happen if the procedure is not performed?

If the anemia is allowed to progress, it may develop into heart failure. In addition, it can also affect the development of the fetus’ tissues and organs. In either case, fetal death is a possibility if anemia is left untreated.

What are the indications for Intrauterine Fetal Blood Transfusion?

Maternal infection by Parovirus B19, Rh incompatibility, physiologic abnormalities of the red blood cell, or other causes of fetal anemia are indications for Intrauterine Fetal Blood Transfusion.  ‍

What is the success rate?

Intrauterine Fetal Blood Transfusion has greatly reduced the risk of fetal death due to anemia. Before this procedure was introduced, there was a 50% chance of death from fetal anemia. However, transfusions have reduced that number to 5 – 9%.

Can I travel after the procedure?

Take some time off to rest after the procedure. It’s important that you’re within range of your hospital for at least 3 days post-operation, just to make sure you can go in immediately should any complications arise. Doctors typically recommend holding off on traveling within the first week after the procedure.

How painful will this procedure be?

Sedatives and pain relievers will be given to you before the procedure begins. Women often describe the procedure as “uncomfortable” rather than painful. Local anesthesia is administered to your abdomen during the procedure. Once the drug takes effect, you should feel a bit of pressure on the area where the needle is inserted. If you feel like the pain becomes unbearable, inform your doctor about it.

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