Fetal Transfusions - Gynecology

What are Fetal Transfusions?

Fetal transfusions are medical procedures performed to treat conditions in the fetus that require the replacement or supplementation of blood. These procedures are often necessary when the fetus is suffering from severe anemia, typically due to red blood cell destruction caused by conditions such as Rh disease or other hemolytic diseases of the fetus.

When are Fetal Transfusions Needed?

Fetal transfusions are generally indicated in cases where there is evidence of severe fetal anemia. This can be detected through ultrasound findings of fetal hydrops fetalis, abnormal Doppler studies showing increased middle cerebral artery peak systolic velocity (MCA PSV), or low hematocrit levels on fetal blood sampling.

How are Fetal Transfusions Performed?

The procedure is typically performed under ultrasound guidance. There are two main types of fetal transfusions: intrauterine and intraperitoneal. Intrauterine transfusions involve inserting a needle into the umbilical vein to directly transfuse blood into the fetal circulation. Intraperitoneal transfusions involve injecting blood into the fetal abdominal cavity, where it is absorbed over time.

What are the Risks Involved?

While fetal transfusions can be life-saving, they do carry certain risks. These include preterm labor, infection, bleeding, and in rare cases, fetal death. However, the benefits often outweigh the risks, especially in severe cases of fetal anemia where the alternative could be fatal for the fetus.

What are the Success Rates?

The success rates of fetal transfusions are generally high, especially when performed by experienced specialists in a controlled setting. Advances in ultrasound technology and improved techniques have significantly increased the safety and efficacy of these procedures.

Post-Procedure Care

After the transfusion, continuous monitoring of the fetal well-being is crucial. This includes regular ultrasound examinations and possibly additional transfusions, depending on the severity of the initial condition. The goal is to manage the anemia and any underlying conditions until the fetus reaches a gestational age where it can be safely delivered.

Conclusion

Fetal transfusions are a critical intervention in the management of severe fetal anemia and other related conditions. While they come with certain risks, the benefits often outweigh these, making them a vital tool in modern prenatal care. Continued advancements in technology and technique promise to further improve outcomes for affected fetuses and their families.