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An Intrauterine transfusion (IUT) is a procedure that provides blood to a fetus, most commonly through the umbilical cord. [1] [2] It is used in cases of severe fetal anemia, such as when fetal red blood cells are being destroyed by maternal antibodies, or parvovirus B19 infection, homozygous alpha-thalassemia, or twin-to-twin transfusion syndrome. [3]
Blood compatibility testing is routinely performed before a blood transfusion.The full compatibility testing process involves ABO and RhD (Rh factor) typing; screening for antibodies against other blood group systems; and crossmatching, which involves testing the recipient's blood plasma against the donor's red blood cells as a final check for incompatibility.
Therefore, in those with no bleeding or only "dry" bleeding, the threshold for transfusion should be between 5,000 and 10,000/μL. A more conservative threshold of 20,000/μL should be used in those with a fever or other risk factors for bleeding. Those with active bleeding or prior to surgery should have a threshold of 50,000/μL.
Higher platelet transfusion thresholds have been used in premature neonates, but this has been based on limited evidence. [19] There is now evidence that using a high platelet count threshold (50 x 10 9 /L) increases the risk of death or bleeding compared to a lower platelet count threshold (25 x 10 9 /L) in premature neonates. [20]
For example, when a mother experiences severe blood loss during pregnancy, [134] ambulances are able to arrive with blood stored in portable, FDA listed blood refrigerators, similar to those found in blood banks. Once the infusion is given on scene, the patient and the ambulance have more time to get to a hospital for surgery and additional ...
Treatments that are temporary include intrauterine blood transfusion of the anemic donor twin or exchange transfusions, which remove blood from the recipient twin and then transfusion of the donor. [8] Treating TAPS with fetal laser coagulation of vascular anastomoses is the only potentially effective modality. [9]
Mothers who are Rh negative (A−, B−, AB−, or O− blood types) and have anti-D antibodies (found on the antibody screen) need to determine the fetus's Rh antigen. If the fetus is also Rh negative (A−, B−, AB−, or O− blood types) then the pregnancy can be managed like any other pregnancy.
The acardiac twin is a parasitic twin that fails to properly develop a heart, and therefore generally does not develop the upper structures of the body. The parasitic twin, little more than a torso with or without legs, receives its blood supply from the host twin by means of an umbilical cord-like structure (which often only has two blood vessels, instead of three), much like a fetus in fetu ...