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, M. J. Raphael, M.B., M.R.C.P., F.F.R., D.M.R.D., D.Obst.R.C.O.G. Search for other works by this author on: Oxford Academic H. Gordon, M.B., F.R.C.S., M.R.C.O.G. Radiodiagnostic Department, Institute of Obstetrics and Gynaecology and Institute of Child Health, Postgraduate Medical School of London , Du Cane Road, London, W.12 Search for other works by this author on: Oxford Academic D. Schiff, M.D. Radiodiagnostic Department, Institute of Obstetrics and Gynaecology and Institute of Child Health, Postgraduate Medical School of London , Du Cane Road, London, W.12 Search for other works by this author on: Oxford Academic
British Journal of Radiology, Volume 40, Issue 475, 1 July 1967, Pages 520–527, https://doi.org/10.1259/0007-1285-40-475-520
Published:
29 May 2014
Article history
Received:
01 November 1966
Published:
29 May 2014
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M. J. Raphael, H. Gordon, D. Schiff, Radiological Aspects of Intra-uterine Blood Transfusion, British Journal of Radiology, Volume 40, Issue 475, 1 July 1967, Pages 520–527, https://doi.org/10.1259/0007-1285-40-475-520
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Abstract
Direct intra-uterine transfusion of the foetus, for the treatment of rhesus iso-immunisation, was performed in 23 single babies and three sets of twins. Needling under radiological control was performed 49 times. Cases were selected on the basis of an obstetric history of babies affected by haemolytic disease and by spectrophotometric analysis of the liquor.
Only those babies in whom intra-uterine death before the 34th week of pregnancy was considered a likely outcome were chosen for transfusion.
The technique consisted of introducing O Rh negative red cells into the foetal peritoneal cavity where they were absorbed directly into the circulation and could combat the anaemia which we feel is the underlying basis of erythroblastosis foetalis. An attempt was made to opacify the foetus the night before the radiographic part of the procedure, to facilitate needling in the X-ray department. A preliminary film was taken with markers, and then needling of the baby's peritoneal cavity under fluoroscopic control was undertaken. When a test injection of contrast medium suggested that the needle was correctly positioned, a catheter was threaded down the needle which was then removed. The catheter was opacified and a check film taken to confirm that it lay in the peritoneal cavity. A blood transfusion was then given after aspirating any ascitic fluid.
The catheter may be left in situ but its position must be checked by radiography before further transfusions can be made.
Of the 29 foetuses transfused on one or more occasions ten were still-born, and of the 17 live births ten survived. In all live births, transfused cells could be demonstrated in cord blood.
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