Medics at Kenyatta National Hospital have successfully transfused a baby while still in the mother’s uterus, a major milestone in the country’s foetal medicine.
The highly delicate procedure, known as the Intrauterine Foetal Transfusion, was undertaken by a team of four doctors who included specialists Dr Rosa Chemwey, Dr Flavia Ogutu, and Dr Ikol Adung’o, as well as Dr Kunjira Murayi, an interventional radiologist.
An intrauterine transfusion is a procedure in which red blood cells from a donor are injected into the foetus. Intrauterine transfusion may be recommended when a foetus has anaemia–low red blood cell count.
Using ultrasound to determine the position of the foetus and placenta, the surgeon inserts a needle into the mother’s abdomen and then into the umbilical vein or the foetus’ abdomen.
Red blood cells that are compatible with the foetus’ blood type are passed through the needle into the foetus. Foetal transfusions may need to be repeated every few weeks until the foetus is ready to be born.
The mother is given antibiotics, local anaesthesia, and IV sedation, which also sedates the foetus, which may be given additional medication to stop movement
According to Dr 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 while referring to the disease where a baby’s red blood cells break down quickly.
“We are indeed very determined to ensure this particular pregnancy succeeds. We hope for positive outcomes. This baby is 25 weeks, three days old.”Dr Rosa Chemwey
She said the baby had severe anaemia because it was theseus alloimmunized, 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 said.
According to the specialists, the transfusion procedure takes between 30min to an hour. “We transfused between 80-100mls of packed red cells. This blood is special as it is O- negative Leukoreduced, hemoconcentration, CMV negative, and irradiated to make it very safe for the baby,” Dr Chemwey said.
Kenyatta National Hospital Chief Executive Officer Dr 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,”Kamuri said.