In the management of severe Rh alloimmunisation with fetal hydrops at 26 weeks, the treatment of choice is:
- A Intraperitoneal fetal transfusion alone
- B Immediate delivery by caesarean section
- C Intravascular fetal blood transfusion via cordocentesis ✓
- D Plasmapheresis of the mother
Correct answer: C. Intravascular fetal blood transfusion via cordocentesis
Explanation
Intravascular fetal blood transfusion (IVT) through umbilical vein cordocentesis is the gold standard for managing severe fetal anaemia and hydrops from Rh isoimmunisation. It provides immediate correction of fetal haematocrit, resolves hydrops, and improves perinatal survival. Intraperitoneal transfusion has reduced efficacy in hydropic fetuses due to impaired absorption. Immediate delivery at 26 weeks carries high prematurity risk. Maternal plasmapheresis is an adjunct in extreme sensitisation before cordocentesis is feasible.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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