Intrauterine Fetal Blood Transfusion for Rh Disease

Treatment Overview

An intrauterine transfusion provides blood to an Rh-positive fetus when fetal red blood cells are being destroyed by Rh antibodies.

A blood transfusion is given to replace fetal red blood cells that are being destroyed by the Rh-sensitized mother's immune system. This treatment is meant to keep the fetus healthy until he or she is mature enough to be delivered.

Transfusions can be given through the fetal abdomen or, more commonly, by delivering the blood into the umbilical vein or artery. Umbilical cord vessel transfusion is the preferred method, because it permits better absorption of blood and has a higher survival rate than does transfusion through the abdomen.^{footnote 1}

An intrauterine fetal blood transfusion is done in the hospital. The mother may have to stay overnight after the procedure.

• The mother is sedated, and an ultrasound image is obtained to determine the position of the fetus and placenta.
• After the mother's abdomen is cleaned with an antiseptic solution, she is given a local anesthetic injection to numb the abdominal area where the transfusion needle will be inserted.
• Medicine may be given to the fetus to temporarily stop fetal movement.
• Ultrasound is used to guide the needle through the mother's abdomen into the fetus's abdomen or an umbilical cord vein.
• A compatible blood type (usually type O, Rh-negative) is delivered into the fetus's umbilical cord blood vessel.
• The mother is usually given antibiotics to prevent infection. She may also be given tocolytic medicine to prevent labor from beginning, though this is unusual.