Doctors at the Rajiv Gandhi Government General Hospital (RGGGH) have performed an ultrasound-guided intrauterine cord blood transfusion to save a 36-week-old foetus with anaemia. It was a case of Rh (rhesus) incompatibility as the 26-year-old woman, who was in her second pregnancy, was Rh-negative and the foetus was Rh-positive.
The woman was delivered of a baby weighing 2.37 kg on Thursday. According to E. Theranirajan, dean of RGGGH, the hospital was the first in the government sector to have performed the fetal therapy successfully. The woman was brought to the RGGGH’s Barnard Institute of Radiology from one of its affiliated institutions — Institute of Obstetrics and Gynaecology and Hospital for Women and Children, Egmore.
A team headed by R. Ravi, Director of Barnard Institute of Radiology, performed the procedure on March 30. “When a Rh-negative mother carries an Rh-positive foetus, the father being Rh positive, during the birth of the child, the Rh-antibodies will develop in the mother’s blood. During her subsequent pregnancy, if the foetus is Rh-positive, there is a possibility of Rh incompatibility, a clinical scenario where the mother’s Rh antibodies destroy the blood cells of the foetus,” Dr. Theranirajan, a paediatrician and neonatologist, said.
Usually, in patients with Rh-negative, the firstborn, even with an incompatible blood group, would invariably be normal, he said, adding: “The mother should be given anti-D immunoglobulin within 24 to 48 hours of delivery to prevent antibodies formation. If missed or delayed, the second baby with Rh positive is likely to be affected.”
“If this foetal anaemia is not corrected, it could lead to fetal hydrops, fluid accumulation in the body resulting in cardiac failure. It was to prevent this that we performed intrauterine cord blood transfusion,” Dr. Ravi said.
In an ultrasound-guided procedure, doctors did an intrauterine blood transfusion into the umbilical cord of the Rh-positive anaemic foetus. Blood bank doctors arranged for O-negative fresh blood, checked for compatibility, irradiated it for leukocyte removal and transfused it in record time. Under the guidance of a visiting consultant, they transfused 80 ml to the foetus and raised its haemoglobin level, doctors said.
