My baby needs a blood transfusion before birth

Introduction

Your baby needs an intrauterine blood transfusion (IUT) whilst in your womb because an ultrasound scan has indicated that your baby may be anaemic. This is a highly specialist procedure performed by Fetal Medicine Specialists at the Royal Victoria Infirmary in Newcastle upon Tyne. Please read the information in this leaflet carefully and ask any questions.

Do I need to take any special measures to prepare for the IUT?

We will need to take some blood samples from you before your appointment to organise the correct type of blood for your baby. You do not need to starve for your appointment, but we advise you only have a light meal before you attend. You can eat and drink as normal after the procedure.

You may wish to bring someone with you to support you during your appointment and to help you home safely later in the day.

What happens when I arrive for my appointment?

You will have an ultrasound scan before the procedure. This allows the consultant to plan how the IUT will be done. Another blood sample may also be needed from you. We will ask you to sign a consent form and place a name band on your wrist. You do not need to wear a hospital gown but just ask if you would prefer to.

Are there any risks involved with an IUT?

There is a small risk of complications due to the procedure. These include the risk of early labour, miscarriage or stillbirth. These risks depend upon individual circumstances and will be discussed with your fetal medicine consultant. If, however, the baby does not receive treatment and becomes severely anaemic then this can lead to fluid retention and swelling (hydrops), heart failure and stillbirth. Generally the benefit outweighs the risk for treating a baby with severe anaemia.

What happens when I go into the scan room?

• You will lie on the ultrasound scan couch.
• You may or may not wish to watch on the monitor. Please let staff know if you wish it to be switched off.
• The consultant and midwife will wear sterile gowns, your abdomen will be washed with antiseptic solution and sterile sheets placed over you to minimise the risk of infection to you and to the baby.
• Using a fine needle, you will be given a local anaesthetic injection in your abdomen to numb a small area of skin and to ensure you feel as little discomfort as possible. You may feel a stinging sensation for a few minutes whilst the anaesthetic works.
• Whilst scanning you, the consultant will then guide a needle through the skin and fatty abdominal tissues and into the uterus. Some feel a fleeting abdominal cramp like sensation at this time.
• A small blood sample will then be taken from the baby’s umbilical cord or abdomen, which is tested immediately to confirm the presence of anaemia. If the baby is found to be anaemic we will give a transfusion of blood through the same needle. The consultant will continue to scan the baby until the transfusion is complete and then will remove the needle. We will clean your abdomen and apply a small dressing to where the needle has been placed.

What happens after the IUT?

You will usually stay in our department for up to an hour following the IUT. Occasionally you may need to stay for longer, if you are uncomfortable or experiencing contraction type pains. Rarely, some women need an overnight stay until this settles down.

We will arrange your next appointment usually within 1-2 weeks, unless we plan to arrange your delivery.

What happens when I go home?

We suggest you rest for the next 24-48hours as you may have some cramp like discomfort. You may take paracetamol to ease this discomfort. It is safe to have a bath or shower, don’t worry if your dressing falls off, you do not need to replace this.

Is there anything I need to be aware of?

If you have any bleeding, any loss of fluid, any severe abdominal pain or worried about your baby’s movement’s please the maternity department at your local hospital for a check-up, or if you are booked at the RVI to contact the MAU.

Will I need to have another IUT?

The consultant will advise you whether this is needed. This usually depends on the results of further scans. If the baby appears to be anaemic again we may suggest further transfusions or we may plan to deliver your baby if you are over 34 weeks gestation. In some pregnancies we may need to perform blood transfusions every 2-4 weeks until we would safely recommend delivery of the baby.

For further information

For further information please contact:

Fetal Medicine Department,
Royal Victoria Infirmary
(0191) 2825837
Monday –Friday 9-5pm

Be sure to ask questions to the doctor supplying you with this leaflet and make a note of any questions you would like to ask at your next Fetal Medicine Unit appointment.

Antenatal Results and Choices
0845 077 2290 or 0207 713 7486 via mobile

North of Tyne Patient Advice and Liaison Service (PALS)
0800 0320202
Monday to Friday 9.00-4.30pm (answer phone out of hours)
Email: northoftynepals@nhct.nhs.uk