Doctors at Kenyatta National Hospital have successfully transfused a baby while still in the mother’s uterus.
The highly delicate procedure, known as the Intrauterine Fetal Transfusion is a milestone in foetal medicine by local experts.
A team of four specialist doctors conducted the procedure in which red blood cells from a donor are injected into the fetus.
Intrauterine transfusion may be recommended when a fetus has anaemia (lowered blood cell count).
They include Rosa Chemwey, Flavia Ogutu, Ikol Adung'o and Kunjira Murayi, an Interventional Radiologist.
They were assisted by Benson Nyankuru and Redempata Mumo who are nurses, and Tony Wainaina, a reproductive Health Clinical Officer.
Using ultrasound to determine the position of the fetus and placenta, the surgeon inserts a needle into the mother's abdomen and then into the umbilical vein or the fetus' abdomen.
Red blood cells that are compatible with the fetus’ blood type are passed through the needle into the fetus.
Fetal transfusions may need to be repeated every few weeks until the fetus is ready to be born.
The mother is given antibiotics, local anaesthesia, and IV sedation, which also sedates the fetus.
The fetus may be given additional medication to stop movement.
According to Chemwey, out of the four pregnancies, the mother only had one successful delivery.
“The mother only has one baby, the last two died of a blood complication known as hemolytic disease of the newborn,” she said.
The hemolytic disease is a blood disorder that occurs when the blood types of a mother and baby are incompatible.
“We are indeed very determined to ensure this particular pregnancy succeeds. We hope for positive outcomes. This baby is 25 weeks, three days old,” Chemwey added.
She said the baby had severe anaemia because the baby was ‘rhesus alloimmunized’.
This is a situation in pregnancy when the maternal red blood cells (RBCs) lacking the rhesus antigen are exposed to rhesus-positive red blood cells through the placenta leading to the activation of the maternal immune system.
“So the mum’s antibodies destroy the baby’s blood, which then develops into anaemia over time,” she described.
According to the specialists, the transfusion procedure takes between 30 minutes to an hour.
“We transfused between 80-100mls of packed red cells. This blood is special as it is Onegative Leucoreduced, hemoconcentrated, CMV negative, and irradiated to make it very safe for the baby,’ she said.
KNH CEO Evanson Kamuri hailed the KNH team for another milestone.
“This is foetal medicine and an institutional landmark. We have attained yet another achievement in fulfilling our mandate as a top premier referral hospital.”
“I’d like to thank the team of doctors and those assisting them for the splendid work done. This confirms that we have the very best medics here at KNH.”
