AM23-SN-08-O: Intrauterine Transfusions: Transfusing the Tiniest, Is It The Trickiest? (Enduring)

Intrauterine transfusion (IUT) is a mainstay of antenatal treatment for severe fetal anemia, most often secondary to maternal alloimmunization, with demonstrated improvement in outcomes. IUT is an invasive, technically challenging procedure with specific blood component requirements that is usually performed at specialized centers. Significant variability exists with regard to IUT performance and blood component selection and modifications among centers within the United States and internationally. Successful IUT requires a coordinated, multidisciplinary effort with particular emphasis on communication. There is a lack of standardization and current practices for provision of red blood cells (RBC) and their subsequent modifications reflecting expert opinion and historical single-center experiences. This session aims to present a comprehensive, multi-center overview of IUT, focusing on practical considerations from a combined Maternal-Fetal Medicine and Transfusion Medicine perspective for an audience of transfusion medicine physicians, trainees, and clinical laboratory scientists. The session will cover the clinical indications for IUT and calculations about the blood volume required to correct fetal anemia by IUTs. The steps involved in RBC Product Selection and component processing and modifications for Intrauterine Transfusion and the specific role of Transfusion Medicine and Blood Banking Service will be discussed. Finally, the under-recognized complications, documentation and regulatory issues as it relates to IUT will be discussed.The idiosyncrasies of transfusion documentation and record keeping will be discussed: Per AABB standards, all transfusions must be documented under the patient’s medical record number and any transfusion-related adverse events. Ethical considerations for documentation of intrauterine transfusion for a fetus that is not yet born will be discussed.