![]() Fetal blood sampling is indicated if severe anaemia before 24 weeks gestation is suspected, if there has been a previous intrauterine death, or if there is a rapid increase in maternal red cell alloantibody levels. High-risk pregnancies are monitored by weekly fetal Doppler ultrasound scans to measure middle cerebral artery peak systolic velocity, an indication of the severity of fetal anaemia, and regular ultrasound monitoring of fetal growth. The objective of red cell IUT is to prevent or treat life-threatening fetal anaemia (hydrops fetalis) and allow the pregnancy to continue to a stage where a viable baby can be delivered (ideally at least 36 weeks gestation). Maternal aspects of the management of HDFN are covered in Chapter 9. 10.1.1: Intrauterine transfusion of red cells for HDFN Even in the most expert hands IUT carries a risk of fetal death of 1–3% per procedure and fetomaternal haemorrhage may cause further sensitisation and worsening of HDFN. This is a highly specialised area of medical practice requiring close collaboration between experts in fetal medicine, haematology and blood transfusion, and rapid access to blood counting. The most common indications for intrauterine transfusion (IUT) are red cells for prevention and treatment of fetal anaemia due to haemolytic disease of the fetus and newborn (HDFN) or parvovirus infection and platelets for neonatal alloimmune thrombocytopenia (NAIT). Annex 6: Advanced Therapy Medicinal Products (ATMPs).Annex 5: Blood Components for Contingency Use.Annex 2: ISBT 128 check character calculation. ![]()
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