Intrauterine Transfusion of Foetus in Haemolytic Disease

Abstract

In the management of the pregnancy complicated by rhesus sensitization the guidance given by amniotic-fluid pigmentation (Bevis, 1956 ; Walker, 1957 ; Mackay, 1961 ; Liley, 1961,1963) has greatly reduced the perinatal mortality from haemolytic disease. In the National Women’s Hospital, Auckland, with a policy of selective induction based on amniocentesis findings, this perinatal mortality has fallen steadily from 22% in 1957–8 to 9% in 1962. It was obvious that no further reduction could be expected from conventional treatment when of 7 perinatal deaths in 80 consecutive rhesus-sensitized pregnancies one baby had multiple congenital abnormalities and the other six were all hydropic before 34 weeks’ gestation. Transfusion in utero appeared the logical procedure for these very severely affected babies early in the third trimester, and intraperitoneal transfusion seemed the simplest technique.