In Rh isoimmunisation with hydrops fetalis detected at 24 weeks (peak systolic velocity in middle cerebral artery > 1.5 MoM), the procedure of choice is:

• A Immediate delivery by caesarean section
• B Intraperitoneal fetal transfusion
• C Intravascular intrauterine transfusion via umbilical vein ✓
• D Maternal intravenous immunoglobulin

Explanation

Intravascular intrauterine transfusion (IUT) via cordocentesis into the umbilical vein under ultrasound guidance is the treatment of choice for severe fetal anaemia from Rh isoimmunisation, including hydrops fetalis, at gestations too early for delivery (< 34 weeks). It allows precise correction of anaemia with O-negative, CMV-negative, irradiated, leucodepleted packed red cells. Intraperitoneal transfusion is an older technique with slower absorption and is used when intravascular access fails. MCA-PSV > 1.5 MoM indicates severe anaemia requiring intervention.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.