Intrauterine Blood Transfusion (IUT)
What is Intrauterine Blood Transfusion?
Intrauterine blood transfusion (IUT) is a specialized procedure performed to treat fetal anemia, often due to Rh incompatibility or other causes. It involves transfusing compatible, packed red blood cells directly into the fetal circulation while still in the womb.
Why is it done?
- Treat severe fetal anemia to prevent heart failure (hydrops fetalis)
- Manage Rh alloimmunization where maternal antibodies attack fetal red cells
- Address anemia from fetal infections (e.g., parvovirus B19)
- Support fetal well-being and improve survival in high-risk pregnancies
When is it performed?
IUT is typically performed after 18 weeks of gestation when fetal anemia is confirmed by Doppler ultrasound or cordocentesis and the fetus shows signs of distress or hydrops.
How is the procedure done?
- Under ultrasound guidance, the fetal umbilical vein or intrahepatic vein is accessed with a fine needle.
- Packed red blood cells, cross-matched and irradiated, are transfused slowly
- Fetal heart rate and well-being are monitored throughout the procedure
- The transfusion volume is calculated based on fetal weight and severity of anemia
Benefits and Risks
Benefits:
- Corrects fetal anemia and reverses hydrops
- Improves chances of survival until delivery
Risks:
- Miscarriage or preterm labor (1–5%)
- Infection, bleeding, or fetal injury
- Maternal sensitization if Rh-negative
Frequently Asked Questions (FAQs)
How do we know the fetus needs IUT?
Fetal anemia is diagnosed by middle cerebral artery Doppler and confirmed by cord blood sampling.
Is the procedure safe?
It carries risks but can be life-saving when fetal anemia is severe.
How often may I need transfusions?
Repeat IUTs may be required every 2–4 weeks until fetal maturity.
Will I need a cesarean delivery?
Delivery mode depends on fetal and maternal condition at term.
What preparation is needed?
Maternal blood group and antibody status are confirmed; you may need Rh immunoglobulin.