3D baby scans

Fetal Treatment

Fetal Treatment

  1. Intra-uterine transfusion
  2. Laserablation

Intra-uterine transfusion:

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. 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.

After 24 weeks an intrauterine fetal blood transfusion is done in the hospital. The mother may have to stay overnight after the procedure.

What To Expect After Treatment

A short recovery period (approximately 1 to 3 hours) is necessary to allow the mother’s sedatives to wear off.  If the fetus was given medicine to prevent movement, it may be several hours until the mother can feel the fetus moving again.

Why It Is Done

A sensitized mother’s immune system can destroy a large amount of fetal red blood cells, causing severe anemia. Intrauterine blood transfusions are done when:

In a severely affected fetus, transfusions are done every 1 to 4 weeks until the fetus is mature enough to be delivered safely. Amniocentesis may be done to determine the maturity of the fetus’s lungs before delivery is scheduled.

How Well It Works

Fetal survival after transfusion depends upon the severity of the fetus’s illness and the method of transfusion. Overall, after intrauterine transfusion through the umbilical cord:

Risks

Intrauterine transfusions may cause:

Laser surgery

Twin-twin transfusion syndrome (TTTS) is a condition in which the blood passes unequally between identical twins that share a placenta (monochorionic). Monochorionic twins are a type of identical twins that share a placenta. Within the shared placenta are blood vessels that connect the blood supply of the two fetuses, allowing blood to flow between the twins. In about 15 percent of monochorionic, diamniotic (two amniotic sacs) twins, the blood flow becomes unbalanced, leading to a condition known as Twin-Twin Transfusion Syndrome (TTTS).

In twin-twin transfusion syndrome, the smaller twin (donor) pumps blood to the larger twin (recipient), causing the recipient twin to receive too much blood and the donor to receive too little. The increased volume of blood causes the recipient twin to produce more than the usual amount of urine, which can result in a large bladder, too much amniotic fluid (known as polyhydramnios) and hydrops, a prenatal form of heart failure. The donor twin produces less than the usual amount of urine, resulting in low or no amniotic fluid surrounding it (oligohydramnios) and a small or absent bladder. Without intervention, the condition can be fatal for both twins.

Management of TTTS may include any of the following: