Safety of Intrauterine Transfusion Performed Beyond 34 weeks of Gestation

To describe (1) procedure-related complications, and (2) gestational age (GA) at delivery in patients who received their final intrauterine transfusion (IUT) at ≥ 34 weeks 0 days versus at < 34 weeks 0 days.

This was a retrospective study of pregnancies treated with IUT. Procedure-related complications were defined as any of the following within 48 h of IUT: (1) rupture of membranes or preterm delivery, (2) intrauterine infection, (3) fetal death, (4) fetal compromise resulting in emergency cesarean, or (5) neonatal death. Patient and procedural characteristics were described among patients with final IUT at ≥ 34 weeks 0 days and at < 34 weeks 0 days.

We studied 94 pregnancies with 237 IUTs; 35 (37.2%) had their last IUT at ≥ 34 weeks 0 days and 59 (62.8%) had their last IUT at < 34 weeks 0 days. Three procedure-related complications occurred (1.3% of procedures, 3.2% of pregnancies). All resulted in emergency cesarean section; 1 case performed at < 34 weeks 0 days resulted in neonatal death. The remaining 2 occurred during IUT at ≥ 34 weeks 0 days. Pregnancies with the last IUT at ≥ 34 weeks 0 days delivered at a median GA of 37.1 weeks.

Complications were rare. IUT performed at ≥ 34 weeks 0 days appeared safe.