Intrauterine Fetal Blood Transfusion

Intrauterine fetal blood transfusion
Intrauterine fetal blood transfusion (IUFBT) is a technique used to transfuse blood to the fetus while it is still in the uterus. The following are the indications for IUFBT:

1. Rh isoimmunization: When an Rh-negative mother conceives an Rh-positive fetus, the mother’s immune system creates antibodies that attack the fetus’s red blood cells. This can result in severe fetal anemia and even death. IUFBT is used to transfuse Rh-negative blood cells to the fetus to prevent anemia.

2. Other blood group isoimmunization: Similar to Rh isoimmunization, when there is a mismatch between the mother’s and fetus’s blood type, the mother’s body may create antibodies that attack the fetus’s red blood cells. IUFBT is used to transfuse blood cells of the same type as the fetus to prevent anemia.

3. Parvovirus B19 infection: This virus can cause a severe form of fetal anemia called fetal hydrops. IUFBT is used to transfuse blood to the fetus to treat anemia.

4. Twin-to-twin transfusion syndrome: This syndrome occurs in identical twins who share a placenta. One twin gets more blood flow than the other, causing the donor twin to become anemic and the recipient twin to become overloaded with blood. IUFBT is used to transfuse blood to the donation twin to treat anemia.

5. Fetomaternal hemorrhage: In rare cases, maternal blood can cross into the fetal circulation, causing fetal anemia. IUFBT is used to transfuse blood to the fetus to treat anemia.

It’s important to note that IUFBT is an invasive procedure with potential risks and should only be performed by a trained specialist.
Intrauterine fetal blood transfusion (IUFBT) can be performed using different techniques depending on the specific indication and the expertise of the medical team. Here are the commonly used techniques:

1. Percutaneous Umbilical Blood Sampling (PUBS) with Transfusion: This technique involves inserting a needle into the umbilical cord, under ultrasound guidance, to directly sample fetal blood and administer the transfusion. It is used for indications such as Rh isoimmunization, blood group isoimmunization, and parvovirus B19 infection.

2. Intrahepatic Transfusion: This technique involves inserting a needle directly into the fetal liver under continuous ultrasound guidance. The blood is transfused into the liver, allowing it to be distributed to other parts of the body. It is commonly used for cases of Rh isoimmunization.

3. Intraperitoneal Transfusion: In this technique, the blood is transfused into the peritoneal cavity of the fetus. This method can be used when direct access to the umbilical cord or liver is not possible. It is typically used for cases of blood group isoimmunization or parvovirus B19 infection.

4. Intravascular Transfusion: This technique involves accessing a large fetal blood vessel, such as the umbilical vein or the fetal heart, to perform the transfusion. It is used for cases of severe and immediate fetal anemia.

The choice of technique depends on factors such as the underlying condition, gestational age, placental position and operator experience, The specific technique and approach will be determined by the medical team based on individual patient circumstances and requirements.