Intrauterine transfusion utilizing ultrasound

Area of Science:

• Obstetrics and Gynecology
• Fetal Medicine
• Maternal-Fetal Medicine

Background:

• Severe Rh sensitization poses a significant risk to fetuses.
• Intrauterine transfusion (IUT) is a critical intervention for erythroblastosis fetalis.
• Traditional IUT techniques often rely on radiation-based imaging.

Purpose of the Study:

• To evaluate the efficacy and safety of ultrasound-guided intrauterine transfusions.
• To compare ultrasound-guided IUT outcomes with historical data from radiation-based methods.
• To advocate for the adoption of ultrasound guidance to reduce fetal radiation exposure.

Main Methods:

• Thirty-seven intrauterine transfusions were performed on 17 severely Rh-sensitized women.
• Needle insertion was guided solely by ultrasound technology.
• Fetal outcomes, including survival rates and presence of ascites, were meticulously recorded.

Main Results:

• An overall neonatal survival rate of 71% was achieved.
• Survival rates were 57% for hydropic fetuses and 80% for those without antenatal ascites.
• Twenty-five percent of survivors received their first transfusion before 26.5 weeks gestation.

Conclusions:

• Ultrasound-guided intrauterine transfusions yield survival rates comparable to established X-ray or fluoroscopy techniques.
• Intrauterine transfusion remains a vital therapy for severely affected fetuses.
• Ultrasound guidance is preferred to minimize in utero radiation exposure for the fetus.