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Article by Doctor Hoang Huong Huyen - Doctor of Hematology - Laboratory Department - Vinmec Times City International Hospital
Fetal blood transfusion is a dangerous complication of pregnancy. If not treated early, this condition can lead to the death rate of the fetus from 90% to 100% or leave severe sequelae for the baby.
1. When is a fetal blood transfusion needed? Fetal blood transfusion is a new technique applied in Vietnam to treat anemic fetuses. Accordingly, the doctor uses a 20G needle, pierces the mother's abdominal wall under ultrasound guidance, and accesses the fetal umbilical cord. Blood is transferred to the fetus through the umbilical cord.
In cases of suitable pregnancy, the doctor needs to evaluate the anemia status of the fetus so that a blood transfusion can be timely. This method is performed after excluding abnormalities in fetal morphology.
Fetal anemia in utero is a condition where the number of red blood cells in the fetal blood decreases, leading to tissue hypoxia that can affect the life of the fetus. In addition, when the fetus is anemic, it will cause the heart to contract more, the need for oxygen supply increases, this situation lasts for a long time, causing myocardial relaxation, fetal edema and death.
2. What causes fetal anemia? The main cause is hemolytic erythrocytosis co-immune disease, mainly Rh incompatibility. In addition, the factors that lead to this condition are:
Fetal infection. The fetus has Thalassemia. Genetic causes such as Fanconi or Diamond Blackfan anemia and metabolic disorders, especially lysosomal pathology...
Giải đáp truyền máu song thai là gì?
3. When to perform fetal blood transfusion? "When to perform fetal blood transfusion?" It is a concern that many parents are concerned about. Accordingly, fetal blood transfusion is performed from 18-35 weeks. In case of blood transfusion before 18 weeks, the vein size is small, difficult to access. Contraindicated to perform fetal blood transfusion at >35 weeks gestation.
4. What are the red blood cell requirements for fetal blood transfusion? Blood group: O/Rh negative. It is necessary to make a compatible reaction with maternal blood before conducting blood transfusion. Red blood cells filter white blood cells. Red blood cells are stored at a temperature of 2oC to 6oC within 05 days from the time of blood collection. Hematocrit from 0.70 to 0.85. Red blood cells can be irradiated when indicated by the clinician. Negative for CMV. Negative for Hemoglobin S.
Truyền máu thai nhi được thực hiện từ 18-35 tuần
5. What is the goal to achieve after a blood transfusion? Pregnancy > 24 weeks: hematocrit about 40-50%. Pregnancy <24 weeks: the first transfusion should not exceed 25% or 4 times the pre-transfusion hematocrit. The 2nd and 3rd infusions are considered after 48 hours, after 7-10 days. 6. Can mother's blood be used for transfusion? Maternal blood is recommended to be used for transfusion to the fetus. Because, when transmitting maternal blood, the fetus will receive many benefits such as:
Reduce the risk of forming antibodies. Reduce the amount of blood that needs to be transfused. Reduce the risk of viral infection. However, due to the requirement of maternal hemoglobin test >125G/l, a large number of pregnant women do not meet this requirement.
In many cases, fetal blood transfusion can cause some dangerous complications such as:
Bleeding of the umbilical cord in the needle puncture area (5%). Fetal death (0.6%). Infection and rupture of membranes (0.1%). Emergency cesarean section (0.4%). Vinmec International General Hospital offers a Package Maternity Care Program for pregnant women right from the first months of pregnancy with a full range of antenatal check-ups, periodical 3D and 4D ultrasounds and other routine tests to ensure the mother is healthy and the fetus is developing comprehensively.
Pregnant women will be consulted and checked for health under the close supervision of experienced and specialized Obstetricians, helping mothers have more knowledge to protect their health during pregnancy as well as reduce reduce complications for mother and child.
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