In a severely anaemic fetus with Rh haemolytic disease requiring intrauterine transfusion, which route is currently preferred?

• A Intraperitoneal transfusion into the fetal peritoneal cavity
• B Intravascular transfusion via cordocentesis into the umbilical vein ✓
• C Intracardiac transfusion under echocardiographic guidance
• D Intra-amniotic instillation of packed red cells

Explanation

Intravascular transfusion through the umbilical vein under ultrasound guidance allows direct correction of circulating haemoglobin, accurate measurement of pre- and post-transfusion haematocrit, and better survival than the older intraperitoneal route. Intraperitoneal transfusion remains a fallback when vascular access is impossible, for example at very early gestations or with an anterior placenta, but it relies on lymphatic absorption and gives less predictable correction.

Reference: Ian Donald's Practical Obstetric Problems, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.