Intrauterine transfusion in the management of severe rhesus isoimmunization.

In the ten years between 1965 and 1974, 2227 patients with rhesus isoimmunization were seen at the Newcastle centre. The antibody titre and previous history were the basis on which patients were selected for amniocentesis and determination of the amniotic fluid bilirubin ratio. There were 288 patients with a bilirubin ratio which was greater than 1-1: of these 206 were treated by intrauterine transfusion (IUT). Evidence for the belief that the treated and untreated groups were similar is presented. The overall survival rates were 44 per cent for cases treated by intrauterine transfusion and 50 per cent for those not treated in this way. The mortality directly attributable to the procedure was at least 20 per cent and did not take into account errors of selection nor accidents associated with amniocentesis.