Bloody Minded Episode 41 - Transfusion for Two | HDFN and Anti-D
Apr 8, 2025
Dive into the intriguing world of blood transfusions in pregnancy, where the stakes are higher than ever. The discussion uncovers the challenges of managing hemolytic disease of the fetus and newborn (HDFN) and the crucial role of anti-D prophylaxis. Learn how intrauterine transfusions work and why CMV seronegative donors are vital for fetal safety. With expert insights on ABO incompatibility and the advancements in non-invasive prenatal testing, this conversation is a blend of vital knowledge and engaging humor.
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Pregnancy Transfusion Blood Selection
- Pregnant women needing transfusion should receive CMV-negative and K-negative blood units when possible.
- Use ABO and Rh matching; irradiation is not required unless other criteria are met.
Neonatal Transfusion Guidelines
- Neonates should receive CMV-negative, group-specific, crossmatched blood up to 28 days old.
- Irradiation is reserved for exchange transfusions or neonates with prior intrauterine transfusions due to potassium sensitivity.
Intrauterine Transfusion Requirements
- Intrauterine transfusions require irradiated, CMV-negative blood less than 5 days old and irradiated within 24 hours.
- Units should be tested for anti-A and anti-B antibodies and matched against maternal serum.
