Carried out successfully in the Jiménez DÃaz Foundation the first transfusion of blood to a fetus inside the womb.
– the procedure was performed without complications in two occasions, in the unit of Prenatal diagnosis, showing a clear improvement
-the child was born healthy in the Jiménez DÃaz Foundation and was discharged three days of birth
Madrid, January 2012.- Prenatal diagnosis of the Di Jiménez Foundation unitAZ, directed by Dr. Javier Plaza Arranz, has made first a blood transfusion intrauterine, i.e. on a fetus in the womb the foetus, of 28 weeks, presented a very serious clinical picture, severe fetal hydrops, which causes anemia and retentions of liquids.
In a first consultation was carried out assessment complete ultrasound and fetal blood Lance, in order to try to determine the cause, performing all kinds of genetic, metabolic and hematologic tests. Once the diagnosis is made, it requested the service of Hematology, directed by Dr. Pilar flames Sillero, valuation and the initiation of procedure on special processing of blood preparation.
Protocol was performed without complications on two occasions, in week 28 and 30 of gestation and in both cases in the unit of Prenatal diagnosis, appreciating a reabsorption of the hydrops and treatment of anaemia; a weekly monitoring of the fetus, especially valuing growth and making estimations of fetal weight, fetal well-being and evaluation of the possibility of a recurrence of fetal anemia, tests using the measurement of the speed of the blood in the Middle using the doppler cerebral artery were performed.
The child was born healthy at the Fundación Jiménez DÃaz on November 20; the results of the medical tests requested by pediatricians to complete his study will ensuring normality, which receives breastfeeding and child that was discharged three days of birth.
It is not uncommon that a newborn premature need a transfusion for various reasons. But any type of fetal therapy finds its sense of accomplishment utero in not having to finish gestation to perform the same postnatal, avoiding treatment, risks resulting from prematurity.
there are two types of techniques for the realization of an intrauterine transfusion, intraperitoneal and the intravascular. Both are always performed under ultrasound control. Initially, the technique used was intraperitoneal, in which blood is injected directly into the peritoneal cavity and the RBCs reach the fetal circulation by lymphatic route.
At present, the technique of choice is the direct infusion to the intravascular route of the umbilical cord, by which we proceed to puncture through the abdomen maternal until reaching the umbilical vessels whose diameter is 2 mm.
Due to different causes can occur an anemia in the fetus, usually because there is an incompatibility in blood with the mother, by certain infections or it presents a chromosomal abnormality, although in very numerous and sometimes causes list, unknown.
Established the diagnosis of fetal anemia, is calculated the forecast of blood transfusion, taking into account different parameters such as weight and the age of the fetus and fetal blood concentration.
The used blood should be blood group O Rh negative with maternal and irradiated cross-tests.
Hematocrit in the blood transfusion should be very high, environment to 85%, to infuse the lowest possible volume that may involve a cardiac overload to the fetus. And in general, the aim is to achieve a fetal hematocrit of 40-50% postransfusional.
