Prior to 1970, haemolytic disease of the newborn was a significant cause of perinatal mortality and morbidity due to the development of anti-D antibodies in the blood of Rhesus (Rh) D negative women carrying a Rh D positive foetus. The introduction of post-natal anti-D immunoglobulin to the mother has significantly reduced the number of such foetal deaths, as well as halting the development of anti-D antibodies in the blood of these women for any potential subsequent pregnancies.
It does still occur in a small proportion of cases and in such circumstances, an intrauterine blood transfusion may be given to replace foetal red blood cells that are being destroyed by anti-D crossing over to the foetus from the mother’s immune system.
A needle is inserted through the mother’s womb into the umbilical cord while the baby is monitored by a MCA Doppler, a scan that measures the speed of blood flow as it pulses through an artery in the foetal brain. The speed of blood flow shows how anaemic the foetus is and whether they need a blood transfusion.
The Irish Blood Transfusion Service’s primary responsibility is the provision of blood and blood products for people in Ireland. The National Maternity Hospital, Holles Street, is the largest maternity hospital in Ireland and the national referral centre for complicated pregnancies, premature and sick infants. Intrauterine Transfusion shows how medical science has developed powerful interventions to tackle previously fatal blood related conditions such as a mother and foetus having opposing Rhesus blood groups. The Rhesus blood group is one of the main blood groups used to group blood types after ABO.