KNH marks new milestone with foetal blood operation

Doctors at Kenyatta National Hospital(KNH) are celebrating yet another milestone in medicine after they successfully carried out blood transfusion on a foetus.

The highly delicate procedure, known as the Intrauterine Fetal Transfusion, was undertaken by a team of four doctors who included specialists Dr Rosa Chemwey, Dr Flavia Ogutu, Dr Ikol Adung’o and Dr Kunjira Murayi (Interventional Radiologist).

They were assisted by nurses Benson Nyankuru, Redempata Mumo and reproductive Health Clinical Officer Tony Wainaina.

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 anemia (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.

Hemolytic disease

Red blood cells that are compatible with the foetus’ blood type are passed through the needle into the foetus. Fetal transfusions may need to be repeated every few weeks until the foetus is ready to be born.

The mother is given antibiotics, local anesthesia, and IV sedation, which also sedates the foetus. The foetus may be given additional medication to stop movement.

According to Dr Chemwey, out of four pregnancies, the mother had only 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, 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,” said Dr Chemwey.

She said the baby had severe anemia because the baby was “rhesus 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 explained.

According to the specialists, the transfusion procedure takes between 30 minutes to an hour.

“We transfused between 80-100mls of packed red cells. This blood is special as it is Onegative Leucoreduced, hemoconcentration, CMV negative, and irradiated to make it very safe for the baby,” she said.

Best medics

Kenyatta National Hospital Chief Executive Officer Dr Evanson Kamuri hailed the KNH team for the 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.”

“I’d like to thank the team of doctors and those assisting them for the splendid work. This confirms that we have the very best medics here at KNH.”

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