1 Department of Pediatrics, University of Vermont College of Medicine, Burlington, Vermont
The best candidate for a fetal transfusion is from 28 to 32 weeks of estimated gestational age, has a high Zone II or low Zone III
O.D. 450 (rising or not decreasing on successive amniocenteses), and does not have hydrops fetalis. If carried out by an experienced team, this procedure has a low risk for the mother, about a 5% mortality for the fetus, and appears to decrease the perinatal mortality rate from erythroblastosis fetalis by about 50%.
The future usefulness of fetal transfusions, however, appears quite limited since the introduction of hyperimmune Rh gamma-globulin.13 They may one day be of only historic interest. But, they have demonstrated that fetal diagnosis and treatment are not beyond reason. This may well be a major contribution to pediatrics.