Intrauterine transfusion utilizing ultrasound.

Thirty-seven intrauterine transfusions were performed on 17 severely Rh-sensitized women utilizing a technique entirely dependent upon ultrasound for needle insertion. The neonatal survival rate was 71%; 57% (4 of 7) of the hydropic fetuses and 80% (8 of 10) of those with no antenatal evidence of ascites survived. Twenty-five percent of the 12 neonatal survivors received their initial transfusion at 26.5 weeks or earlier. These results are comparable to the best of those in series relying on x-ray or fluoroscopy techniques for performing the procedure. Intrauterine transfusion continues to play an essential therapeutic role in the management of the severely affected erythroblastotic fetus. It is recommended that techniques relying on ultrasound be utilized in preference to those using x-ray to reduce radiation exposure in utero.