Intra-uterine transfusion in the management of pregnant women with severe rhesus isoimmunization. I. Indications, technique, and complications.

Abstract

Intra-uterine transfusion may be a life-saving procedure in severe cases of rhesus isoimmunization. Yet it may be technically difficult and poses a real hazard to the fetus. This material consists of 51 intra-uterine transfusions performed in 34 severe rhesus (anti-D) isoimmunized pregnant women. The selection of patients was based upon an evaluation of the severity of fetal erythroblastosis (past obstetric history, serological and amniotic fluid examinations). The major criterion for selection was the concentration of amniotic fluid bilirubin. The technique employed was based upon a fluoroscopic television control system. The most serious complications were blood-stained amniotic samples in 15% of the amniocenteses and vaginal leaking of amniotic fluid and preterm labour after the performance of the intra-uterine transfusions in 33%.