In Utero Exchange Transfusion by Direct Intravascular Injection in Severe Erythroblastosis Fetalis

Abstract

TRADITIONALLY, attempts to give transfusions to severely affected isoimmunized fetuses have involved the intraperitoneal injection of packed red cells.^{1 2 3} The success of this procedure depends on absorption of the blood through the subdiaphragmatic lymphatic vessels of the fetus. Since there may be erratic and inconsistent absorption in severely hydropic fetuses, Rodeck et al.^{4 , 5} instituted fetoscopically directed simple intravascular transfusion.With direct access to the fetal circulation through the umbilical vein, one can determine the extent of fetal anemia and deposit red cells directly into fetal vessels, circumventing the problems of unpredictable absorption from the peritoneal cavity. In addition, the hematocrit . . .