Successful ultrasound-guided intravascular transfusion in severe fetal anemia without blood group incompability.

A 26-year-old patient with chronic acquired pure red cell aplasia had given birth to two infants, both of which died from fetal hydrops and anemia. In her third pregnancy the fetus was diagnosed as being hydropic and anemic in the 24th gestational week. No blood group incompability could be demonstrated. Because of the low gestational age and presence of fetal ascites, intraperitoneal fetal blood transfusion was considered to be without effect, and three fetal intravascular transfusions were therefore performed in the 24th, 26th and 28th gestational weeks. The infant born in the 30th week, is in good health with a normal blood picture, 6 months later. Hydrops and fetal anemia has never been described as a complication of pregnancy in a patient with pure red cell aplasia and it is the first time that intrauterine intravascular fetal transfusion has been used other than for rhesus indication.