Carbon dioxide and horizontal fluoroscopy in intrauterine fetal transfusions.

Abstract

INTRAUTERINE transfusions of packed red blood cells to the erythroblastotic fetus must be performed under radiological guidance. The smaller, more premature fetuses are not candidates for early delivery and require blood replacement until viability is reached. A simplified method of introducing a catheter for intrauterine transfusion is the subject of this report. History Red blood cells have been shown to be absorbed intact from the fetal peritoneal cavity (1). Since the major cause of death of the erythroblastotic fetus prior to viability is anemia, therapeutic efforts are directed to red blood cell replacement by intrauterine transfusion to carry the fetus to viability. Selection of patients for intrauterine transfusion is based upon amniotic fluid analysis for bilirubin and the obstetrical history. Where the amniotic fluid bilirubin level indicates likely fetal death prior to thirty-two weeks gestation, the risk associated with intrauterine fetal transfusion is justified (2–4, 6, 8). The technic as ou...