Intrauterine transfusion complicated by omental herniation of the newborn

Abstract

The treatment of Rh sensitization by the technique of intrauterine transfusion has been employed on a worldwide basis since Liley's first description. 1 Many complications have been reported following the procedure, and the technique employed has been responsible for many of the associated fetal losses. Wong 2 stated that factors that have contributed to fetal deaths include accidental penetration of vital fetal organs and the mechanical and biochemical changes related to the volume and rate of infusion of packed red cells. A further important factor was thought to be related to the number of times the Tuohey needle was inserted to attain intraperitoneal localization. Approximately 33% of his patients required two or three needle insertions. Cunningham 3 points out that infants who have received intrauterine transfusions have an appreciable risk of neonatal hepatitis, which may continue as chronic liver disease. Mendelbaum 4 reported fatal homologous serum hepatitis. Other common complications of this procedure have been premature rupture of the membranes, premature labor, vaginal bleeding, and, more rarely, the development of amnionitis with generalized fetal infection.