Intrauterine_RBC_Transfusion_Dosage_guideline v.1

Intrauterine RBC Transfusion Dosage estimates volume of donor RBCs needed for intrauterine transfusion (IUT).

Maryam Razavi

maryam.razavi@cambio.se

@CambioCDS

To assist with calculation of RBC volume needed for intrauterine transfusion (IUT).

Use in cases of severe fetal anemia, i.e., in hemolytic disease of the fetus and newborn (HDFN) or other rare indications for IUT that can be determined by specialists in high risk pregnancy. Note1: Hematocrit of transfused units varies by the type of storage solution, ranging between 55-85%; for specific information, contact your local blood bank or maternal-fetal medicine expert. Note 2: Transfused blood for IUT should be group O, negative for antigens against which mother has alloantibodies, crossmatch compatible with mother’s plasma, irradiated, CMV seronegative and/or leukocyte reduced, and hemoglobin S negative. Variables: -Fetal weight, gm - Initial fetal hematocrit, %(Estimate via ultrasound) -Goal fetal hematocrit, % - Hematocrit of transfused RBCs,% (Varies by storage solution (range 55-85%); contact blood bank or maternal-fetal medicine expert for specifics) FORMULA Transfusion volume, mL = fetoplacental volume, mL × [ Hct(goal) - Hct(initial) ] / Hct(transfused) Where fetoplacental volume, mL = fetal weight, g × 0.14 mL/g

Not to be used to provide comprehensive or definitive drug information. Always double-check dosing of any drug and consult your institution's blood bank or a pharmacist as necessary.

1. Mandelbrot L, Daffos F, Forestier F, Macaleese J, Descombey D. Assessment of fetal blood volume for computer-assisted management of in utero transfusion. Fetal Ther. 1988;3(1-2):60-6. 2. Plecas DV, Chitkara U, Berkowitz GS, Lapinski RH, Alvarez M, Berkowitz RL. Intrauterine intravascular transfusion for severe erythroblastosis fetalis: how much to transfuse?. Obstet Gynecol. 1990;75(6):965-9. 3. Leduc L, Moise KJ, Carpenter RJ, Cano LE. Fetoplacental blood volume estimation in pregnancies with Rh alloimmunization. Fetal Diagn Ther. 1990;5(3-4):138-46.

OBSERVATION.intrauterine_rbc_transfusion_dosage.v0