What is Intrauterine Transfusion?
Intrauterine transfusion (IUT) is a procedure where donor red blood cells are transfused into the baby to treat severe anemia, often caused by Rh incompatibility or infections like parvovirus B19.

How is the blood transfused to the baby?
A fine needle is inserted through the mother’s abdomen into the baby’s umbilical vein or abdominal cavity under ultrasound guidance.

When is IUT recommended?
IUT is recommended when the baby shows signs of severe anemia, such as changes in blood flow pattern as detected by Doppler scan and fluid accumulation in various organs of fetus on ultrasound examination.

How many transfusions might be needed?
Multiple transfusions may be required, usually every 2–3 weeks, until the baby reaches a safe gestational age for delivery.

Is there any risk to the baby or mother?
While any procedure carries some risk, IUT is generally safe and well-tolerated when done by specialists. However, there’s a small risk of premature labor or infection.

What is RFA used for in fetal treatment?
RFA is used in complicated twin pregnancies (especially TRAP sequence or severe abnormalities in one twin) to safely stop blood flow to a non-viable or high-risk twin to protect the other.

How does the procedure work?
A needle with a radiofrequency probe is guided into the target twin, where it delivers heat to seal off the blood vessels supplying that fetus.

How long does the procedure take?
Typically around 30–60 minutes, depending on the case complexity and fetal position.

Is RFA painful for the mother?
The procedure is done under local anesthesia with sedation. Most mothers feel only mild discomfort and can return home the same day.

What is the success rate?
When performed appropriately, RFA has a good success rate in preserving the healthy twin’s life and reducing complications.

When is bipolar cord coagulation preferred?
It’s preferred when laser therapy isn’t feasible (e.g., unfavorable placental position) or in cases of severe fetal abnormalities where one twin’s survival threatens the other.

What happens during the procedure?
A fetoscope or needle is used to reach the umbilical cord, and bipolar forceps deliver electrical current to seal the vessels and stop blood flow.

Why is it safer in certain cases?
It gives greater control when laser treatment is difficult, and helps avoid emergency deliveries in high-risk pregnancies.

Does the baby feel pain?
No, the fetus does not feel pain during the procedure. The goal is to perform it as early and gently as possible to reduce stress on both mother and baby.

How is the surviving twin monitored afterward?
Frequent ultrasounds and Doppler scans will be done to monitor growth, brain development, and overall health.

What is TTTS and how does laser therapy help?
TTTS (Twin-to-Twin Transfusion Syndrome) occurs when twins share a placenta and have unbalanced blood flow. Laser therapy seals off the shared vessels causing the problem, restoring balance.

How is the procedure performed?
A small camera (fetoscope) is inserted into the womb. Once the abnormal blood vessels are located, a laser is used to close them.

What is the “Solomon technique”?
This is a more advanced method where doctors also coagulate the area between the twins to prevent recurrence of TTTS or TAPS (anemia/polycythemia).

When is the best time to do laser therapy?
Usually between 16 and 26 weeks of pregnancy. Earlier intervention can help improve survival chances and long-term outcomes.

What happens after the procedure?
Most mothers are monitored in the hospital for a day or two. Follow-up scans are scheduled regularly to assess fetal well-being.

What is a fetal shunt and what does it treat?
A fetal shunt is a tiny tube inserted into the baby to drain excess fluid from organs like the bladder, lungs, or chest. It helps prevent damage to developing organs.

Which conditions need shunt placement?
Common indications include lower urinary tract obstructions (LUTO), pleural effusion, or congenital cystic adenomatoid malformation (CCAM).

How is the shunt inserted?
Under ultrasound guidance, a needle delivers a soft double-ended catheter (shunt) into the baby, creating a path for fluid to drain into the amniotic sac.

What are the benefits of a shunt?
It relieves pressure, helps lung development, and may improve kidney function and overall survival.

Is shunting permanent?
No. The shunt usually remains in place until birth or until the fluid re-accumulates. Some babies may still need postnatal surgery.