A transfusion is needed when the fetus has severe anemia. Anemia is a low level of red blood cells. Severe anemia in a fetus can cause death. Anemia can be caused by:

Rh incompatibility—proteins in the mother's blood destroy blood cells in the fetus.
Parvovirus B19 infection—a viral infection in the mother.

Anemia can cause a problem called hydrops. Hydrops is severe, life-threatening swelling in the fetus. A fetal blood transfusion is done to:

Prevent or treat fetal hydrops
Continue the pregnancy

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

Need for cesarean section—if the fetus has problems
Premature rupture of membranes and/or premature labor
Bleeding, cramping, or leaking fluid from vagina
Infection in the uterus or fetus
Injury to the fetus
Giving too much blood
The donor’s blood cells attack the fetus's blood cells—rare

What to Expect

Prior to Procedure

The care team may meet with you to talk about:

Anesthesia
Whether you will need a ride to or from the procedure
Tests that may need to be done before the procedure

Amniocentesis

Before the transfusion, you may be given:

Pain medicine
Medicine to help you relax

Anesthesia

Medicine will be used to numb a small area of the belly.

Description of the Procedure

With IVT, medicine may be used to keep the fetus still for a short time. This will lower the risk of injury to the fetus. During both IVT and IPT, the doctor will watch the fetus with an ultrasound.

A needle will be inserted into the belly. The needle will be passed through the uterus and into the umbilical cord. (With IPT, it will pass in the fetal belly instead of cord.) The donor blood will be passed to the fetus.

A final blood sample will be taken. It will show the change to the fetus's blood.

Transfusions may need to be repeated every 2 to 4 weeks until it is safe to deliver.

How Long Will It Take?

About 1 to 2 hours

Will It Hurt?

There will be some pain and cramping where the needle is inserted. The uterus may feel sore.

Average Hospital Stay

Some people go home the same day. Others may need to stay longer.

Post-procedure Care

At the Care Center

The staff may give you:

Pain medicine
Antibiotics to prevent infection
Medicine to prevent contractions or labor

It may take a few hours to feel the baby move again—if the baby was given medicine.

Call Your Doctor

Call your doctor if you have:

Signs of infection, such as fever or chills
Excess bleeding, redness, swelling, or discharge from the insertion site
Pain you cannot control with the medicine
Problems feeling the baby moving

Know the signs of early labor:

A slow leak or sudden gush of fluid from the vagina
Belly tightening
Back pain that comes and goes
Bleeding from the vagina

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Pregnancy Association
http://www.americanpregnancy.org

The American College of Obstetricians and Gynecologists
http://www.acog.org

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org

Women's Health Matters
http://www.womenshealthmatters.ca

References:

Abbasi N, Johnson JA, et al. Fetal anemia. Ultrasound Obstet Gynecol. 2017;50(2):145-153.

Hemolytic disease of the fetus and newborn (HDFN). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hemolytic-disease-of-the-fetus-and-newborn-hdfn. Accessed July 30, 2021.

Rhesus disease. National Health Services website. Available at: https://www.nhs.uk/conditions/rhesus-disease/treatment/. Accessed July 30, 2021.

Rh factor. American Pregnancy Association website. Available at:
...(Click grey area to select URL)
Accessed July 30, 2021.

Last reviewed July 2021 by Daniel A. Ostrovsky, MD
Last Updated: 7/30/2021

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