BLOOD: Intrauterine Transfusion

Prior to 1970, haemolytic disease of the newborn was a significant cause of perinatal mortality and morbidity due to the development of anti-D antibodies in the blood of Rhesus (Rh) D negative women carrying a Rh D positive foetus. The introduction of post-natal anti-D immunoglobulin to the mother has significantly reduced the number of such foetal deaths, as well as halting the development of anti-D antibodies in the blood of these women for any potential subsequent pregnancies.

It does still occur in a small proportion of cases and in such circumstances, an intrauterine blood transfusion may be given to replace foetal red blood cells that are being destroyed by anti-D crossing over to the foetus from the mother’s immune system.

A needle is inserted through the mother’s womb into the umbilical cord while the baby is monitored by a MCA Doppler, a scan that measures the speed of blood flow as it pulses through an artery in the foetal brain. The speed of blood flow shows how anaemic the foetus is and whether they need a blood transfusion.