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18+ Weeks Gestation
(When Performed)
1–2% Procedure Risk
Per Transfusion
2–4 wks Interval Between
Transfusions
🥇 First in Vidarbha
Dr. Kunda Shahane
What is Fetal Blood Transfusion?

New Blood —
Delivered Directly to Your Baby Before Birth

Intrauterine fetal blood transfusion (IUT) is a life-saving procedure in which donor red blood cells are delivered directly into the baby's umbilical vein — correcting severe anaemia while the baby is still in the womb and the pregnancy can safely continue.

When a baby becomes severely anaemic before birth — most commonly because of Rh alloimmunisation (Rh disease) or parvovirus B19 infection — its heart works harder and harder to deliver oxygen to its organs. Without treatment, this leads to high-output cardiac failure, hydrops fetalis (dangerous fluid build-up throughout the body), and can be fatal. Transfusion reverses this process: the baby's haemoglobin is restored, cardiac function improves, and the pregnancy can continue to a safe gestational age for delivery.

At Mayflower Fetal Medicine Centre, intrauterine fetal blood transfusion is performed under continuous GE Voluson Signature Expert guidance by Dr. Kunda Shahane — the pioneer of this procedure in Vidarbha and the only specialist currently performing it in Central India.

IUT — At a Glance
When: From 18 weeks onwards (earlier if anaemia is critical and risks of prematurity are outweighed)
Access: Umbilical vein via cordocentesis — same fine needle approach
Blood used: Irradiated, CMV-negative, O-negative, leukodepleted packed red cells
Duration: 30–60 minutes per session (includes sampling and transfusion)
Frequency: Every 2–4 weeks, guided by MCA Doppler monitoring
Series ends: When delivery can safely occur (typically 34–37 weeks)
Risk per procedure: ~1–2% at experienced centres
Pioneer: First performed in Vidarbha by Dr. Kunda Shahane — families no longer need to travel to Mumbai
The Clinical Pathway

From Doppler Alert to Transfusion —
The Complete Treatment Journey

Intrauterine transfusion does not happen in isolation — it is the treatment step at the end of a carefully monitored clinical pathway. Understanding the full journey helps families know what to expect at each stage.

1
Maternal Antibody Screening / Infection Diagnosis

The pathway begins when an Rh-negative mother is found to have anti-D (or other) antibodies in her blood during pregnancy — or when a maternal parvovirus B19 infection is confirmed. These are the triggers for close fetal monitoring.

Trigger for Monitoring
2
Serial MCA Doppler Monitoring at Mayflower Clinic

Dr. Kunda Shahane monitors the Middle Cerebral Artery (MCA) peak systolic velocity (PSV) every 1–2 weeks. An anaemic baby has a faster heartbeat, which drives blood more quickly through the MCA — a raised MCA PSV is the first sign that anaemia may be developing. As long as MCA PSV remains below 1.5 MoM (multiples of the median), the pregnancy is monitored closely without intervention.

Non-Invasive Monitoring
3
MCA PSV Crosses Threshold → Cordocentesis to Confirm

When MCA PSV rises above 1.5 MoM — the internationally accepted threshold for likely moderate-to-severe anaemia — cordocentesis is performed. A small sample of fetal blood is collected to directly measure haemoglobin and haematocrit, confirming the diagnosis and calculating the precise volume of blood needed for transfusion.

Diagnostic Procedure
4
Transfusion — Donor Blood Delivered Through the Same Needle

If the haemoglobin confirms significant anaemia, Dr. Kunda Shahane proceeds immediately to transfusion through the same needle — without removal and reinsertion. Specially prepared donor red blood cells are infused slowly into the umbilical vein while the fetal heart rate is monitored continuously throughout. The target haemoglobin is restored to a safe level.

Life-Saving Treatment
5
Post-Transfusion MCA Doppler Reset + Recovery Period

Immediately after transfusion, the MCA PSV falls dramatically — reflecting the corrected haemoglobin. The baby is monitored closely in the clinic and MCA Doppler is rechecked. As the transfused red cells are gradually broken down over 2–4 weeks, the MCA PSV rises again — signalling when the next transfusion is needed.

Recovery and Monitoring
6
Series Continues Until Safe Delivery

Steps 3–5 repeat every 2–4 weeks — as many times as needed — until the baby reaches a gestational age (typically 34–37 weeks) where delivery is safer than continued transfusion. After the final transfusion, delivery is planned and coordinated with the obstetric team. Most babies born after a successful IUT series do well.

Until Delivery
Why Babies Become Anaemic

Causes of Fetal Anaemia Requiring Transfusion

Fetal anaemia severe enough to require intrauterine transfusion has specific causes — all involving the destruction or failure of fetal red blood cell production. Dr. Kunda Shahane manages all of the following conditions at Mayflower Clinic.

Rh Alloimmunisation (Rh Disease)

The most common cause. An Rh-negative mother whose baby is Rh-positive produces antibodies (anti-D) that cross the placenta and destroy the baby's red blood cells. Severity worsens with each affected pregnancy. Prevented by timely Anti-D injections — but if sensitisation has already occurred, serial IUT is the treatment.

Most Common Cause
Parvovirus B19 Infection

Parvovirus B19 (fifth disease) infects fetal red blood cell precursors, halting production for 4–8 weeks. In the second trimester, this can cause severe aplastic anaemia and hydrops. Transfusion "buys time" while the baby's own bone marrow recovers — usually requiring only 1–2 transfusions.

Often Resolves After 1–2 IUT
Other Red Cell Alloimmunisation

Antibodies to other red cell antigens — anti-Kell (Kell system), anti-c (Rh system), anti-E, and others — can cause haemolytic disease of the fetus. Anti-Kell is particularly severe as it suppresses fetal red cell production in addition to destroying existing cells. Management mirrors anti-D disease.

Similar to Rh Disease
Non-Immune Hydrops Fetalis with Anaemia

In some cases of non-immune hydrops (hydrops not caused by antibody-mediated haemolysis), fetal anaemia is discovered as the underlying cause — including in alpha-thalassaemia major (Bart's hydrops). Transfusion may stabilise some of these cases while the full diagnosis is pursued.

Selected Cases
🏅
First in Vidarbha — No Need to Travel to Mumbai or Pune Before Dr. Kunda Shahane established this service at Mayflower Clinic, families diagnosed with Rh disease or fetal anaemia in Central India had no choice but to make the journey to Mumbai or Hyderabad for every transfusion — some as frequently as every two weeks. That journey is no longer necessary. Mayflower Fetal Medicine Centre is the only centre in Vidarbha and Central India where intrauterine fetal blood transfusion is available.
Safety Standards

The Donor Blood — Strictly Specified for Safety

The blood used for intrauterine fetal transfusion is not standard blood bank blood. It must meet very strict specifications to be safe for a fetus — and it is arranged by Dr. Kunda Shahane in advance of every procedure.

Donor Blood Requirements for IUT
Every unit of blood used for fetal transfusion must satisfy all of the following criteria simultaneously
🅾️
O-Negative
Universal donor red cells that won't react with any fetal blood group
☢️
Irradiated
Prevents graft-versus-host disease — essential for all fetal transfusions
🦠
CMV-Negative
Eliminates risk of cytomegalovirus transmission to the immunologically immature fetus
🧫
Leukodepleted
White blood cells removed — reduces transfusion reactions and sensitisation risk
📅
Fresh Blood
Ideally less than 5–7 days old — ensures maximum red cell viability and longer interval to next transfusion
🩺
High Haematocrit
Packed red cells at 70–85% haematocrit — concentrated to minimise the volume transfused into the fetal circulation
Pre-Procedure Assessment

What Dr. Kunda Shahane Reviews Before Each Transfusion

Each transfusion session begins with a complete clinical and ultrasound assessment. No two sessions are identical — fetal position, cord location, and haemoglobin level vary each time.

MCA Doppler Measurement

Current MCA peak systolic velocity is measured and compared to the expected normal range (MoM) for gestational age. This determines whether the threshold for transfusion has been reached.

Fetal Wellbeing Assessment

Biophysical profile or CTG to assess fetal activity, tone, breathing movements, and amniotic fluid — overall fetal wellbeing before a technically demanding procedure.

Cord and Placental Position Mapping

Detailed scan to identify the cord insertion site, fetal lie, and placental position — determining the safest needle entry point for this specific session.

Donor Blood Confirmation

Confirming that the specially prepared donor blood (irradiated, CMV-negative, O-negative) has arrived and is within the acceptable freshness window before beginning. No transfusion proceeds without this confirmation.

Transfusion Volume Calculation

Using the pre-transfusion haemoglobin (measured from the initial blood sample), the estimated fetal weight, and the haematocrit of the donor blood to calculate precisely how much blood needs to be transfused to reach the target haemoglobin level.

Maternal Clinical Review

Review of maternal antibody titres, any interval clinical changes, and confirmation of Rh-negative status and Anti-D prophylaxis — ensuring the maternal health picture is stable before proceeding.

The Procedure

What Happens During the Transfusion — Step by Step

Each IUT session takes approximately 30–60 minutes from needle insertion to completion, though your total time at the clinic will be longer. You will be awake and comfortable throughout.

  • 1
    Pre-procedure ultrasound and safety checks

    Dr. Kunda performs a full assessment — MCA Doppler, fetal wellbeing check, and cord position mapping on the GE Voluson Signature Expert. Donor blood identity and specifications are verified against the patient's details. The procedure does not begin until every check is complete.

  • 2
    Antiseptic preparation and positioning

    The abdominal skin is cleaned with antiseptic solution. You are positioned comfortably on the procedure table. Local anaesthesia is generally not required — the needle is fine and the discomfort is similar to a blood test.

  • 3
    Needle placed into the umbilical vein

    Under continuous real-time ultrasound guidance, a fine needle is directed into the umbilical vein — ideally at the cord insertion into the placenta, where the cord is most stable. The flash of bright fetal blood confirms correct placement in the vein.

  • 4
    Initial fetal blood sample taken

    A small blood sample (1–2 mL) is collected first — sent to the bedside analyser for immediate haemoglobin and haematocrit measurement. This confirms the severity of anaemia and is used to calculate the exact volume of donor blood needed.

  • 5
    Donor blood transfused through the same needle

    The calculated volume of pre-warmed donor packed red cells is transfused slowly through the same needle into the umbilical vein. The fetal heart rate is monitored continuously by the ultrasound operator throughout, and the needle position is checked regularly. The transfusion takes 15–45 minutes depending on the volume required.

  • 6
    Post-transfusion blood sample and fetal heart check

    After transfusion, a second blood sample confirms the post-transfusion haemoglobin — verifying the target level has been achieved. The fetal heart rate and cord entry site are checked by ultrasound before the needle is removed.

  • 7
    Post-procedure monitoring and planning

    You rest at the clinic for 30–60 minutes while fetal heart rate is monitored. Dr. Kunda confirms fetal wellbeing before discharge. The date and timing of the next MCA Doppler check — and the estimated date of the next transfusion — are discussed before you leave.

Between Transfusions — What We Monitor
After each transfusion, Dr. Kunda Shahane schedules serial appointments to track the baby's progress and determine when the next transfusion is needed.
🩺
MCA Doppler
Every 1–2 weeks. Rising PSV signals approach of the next transfusion threshold.
❤️
Fetal Heart Rate
CTG or biophysical profile at each visit to assess overall fetal wellbeing.
📏
Growth Assessment
Growth scan to confirm the baby is growing appropriately despite the anaemia management.
🌊
Amniotic Fluid
Fluid volume monitoring — a change from previous hydrops or oligohydramnios is a sign of clinical response.
🧪
Maternal Antibody
Serial maternal antibody titres track whether sensitisation is stable or worsening between sessions.
📅
Delivery Planning
From 32 weeks, delivery timing is discussed at each visit — balancing the risk of IUT against the risk of prematurity.
After Your Baby's Transfusion — Care Instructions
🏠Rest at home for the remainder of the day. Avoid strenuous activity for 48 hours after each transfusion session.
👶Monitor fetal movements carefully. After a successful transfusion, movements typically improve as the baby's condition improves. Any reduction should be reported immediately.
💊Mild abdominal cramping after the procedure is normal. Paracetamol may be taken. Avoid aspirin and ibuprofen.
📅Keep all scheduled follow-up appointments. MCA Doppler monitoring after transfusion is not optional — it determines the timing of the next life-saving procedure.
💉Rh-negative women receive Anti-D immunoglobulin after each procedure. Confirm your blood group at the first visit.
📞Dr. Kunda Shahane's team is available to address concerns between appointments. Keep the clinic WhatsApp number (+91-8087471244) saved.
⚠️ Contact the clinic immediately if: Reduced or absent fetal movements · Heavy vaginal bleeding · Significant fluid leak · Fever above 38°C · Severe or persistent abdominal pain · Any symptom that concerns you. Do not wait for the next appointment.
WhatsApp 24×7: +91-8087471244 | Call: 0712-669-2706
Before Each Session

Preparing for Your Transfusion Appointment

✓ IUT Appointment Checklist

  • ✓Bring all Doppler reports: The most recent MCA Doppler results, previous transfusion records, and any interval monitoring reports — all essential for pre-procedure assessment.
  • ✓Blood group confirmation: Your blood group and Rh status must be confirmed and on file. The correct donor blood cannot be prepared without this information.
  • ✓Partially full bladder: Drink 2–3 glasses of water 30–45 minutes before. This assists with uterine positioning and cord visualisation.
  • ✓No fasting required: Eat and drink normally before the appointment. Good hydration improves cord visualisation.
  • ✓Bring a companion: Do not drive yourself to or from the appointment. A partner or family member should accompany you every time.
  • ✓Comfortable clothing: Loose, comfortable, two-piece clothing that allows easy access to the abdomen. Avoid tight waistbands.
  • ✓Allow 2–3 hours: Each session involves assessment, the procedure itself, and post-procedure monitoring. Do not plan anything immediately afterwards.
  • ✓Emergency contact saved: Keep Mayflower Clinic's WhatsApp number (+91-8087471244) saved in your phone at all times during your treatment course.
Watch Dr. Kunda Shahane
Invasive Prenatal Procedures at Mayflower Fetal Medicine Centre, Nagpur
Frequently Asked Questions

Your Questions About Fetal Blood Transfusion, Answered

What is intrauterine fetal blood transfusion (IUT)?
Intrauterine fetal blood transfusion is a procedure in which donor red blood cells are delivered directly into the baby's umbilical vein — inside the womb — to treat severe fetal anaemia. It is performed when the baby's haemoglobin falls to a level where normal oxygen delivery to its organs is compromised. Without treatment, severe fetal anaemia causes high-output cardiac failure, hydrops fetalis, and can be fatal. IUT corrects the haemoglobin, gives the heart relief, and allows the pregnancy to continue safely.
Why would my baby need a blood transfusion before birth?
A baby can become severely anaemic in the womb for two main reasons. First, Rh alloimmunisation — where an Rh-negative mother has developed antibodies that cross the placenta and destroy the baby's red blood cells (Rh disease). Second, parvovirus B19 infection — which infects and temporarily destroys the fetal bone marrow's ability to make red blood cells. In both cases, the baby cannot sustain its own haemoglobin, and transfusion is the only available treatment. Without it, the baby may develop hydrops — a life-threatening condition — and die.
How does Dr. Kunda know when the baby needs a transfusion?
Fetal anaemia is monitored non-invasively using Middle Cerebral Artery (MCA) Doppler — an ultrasound measurement that tracks blood flow velocity in the baby's brain. An anaemic baby pumps blood faster to compensate, which shows up as an elevated MCA peak systolic velocity (PSV). When MCA PSV crosses 1.5 times the expected normal value for the gestational age (1.5 MoM), Dr. Kunda proceeds to cordocentesis to directly measure the baby's haemoglobin — and if confirmed, transfusion follows in the same session.
How many transfusions will my baby need?
This depends entirely on the cause and gestational age at which anaemia first develops. For Rh disease, babies typically need 2–5 transfusions spaced 2–4 weeks apart, continuing until delivery can be safely planned at 34–37 weeks. For parvovirus B19, usually 1–2 transfusions are sufficient — the baby's own bone marrow recovers within 4–8 weeks and can then produce red cells normally again. Dr. Kunda Shahane will discuss the expected number of sessions based on your specific clinical situation at the first consultation.
Is fetal blood transfusion available in Nagpur?
Yes — and only at Mayflower Fetal Medicine Centre, Dhantoli, Nagpur. Dr. Kunda Shahane was the first specialist in Vidarbha and Central India to introduce and perform intrauterine fetal blood transfusion. Before she established this service, families in Nagpur, Amravati, Akola, Wardha, and across Vidarbha had no choice but to travel to Mumbai or Hyderabad for every transfusion — sometimes every two weeks. That is no longer necessary. This life-saving service is now available locally.
Will my baby be normal after fetal blood transfusion?
When fetal anaemia is detected early (before severe hydrops develops) and treated promptly with IUT, outcomes are generally very good. Most babies who receive timely transfusions are born in good condition and develop normally. The critical factor is early detection through regular MCA Doppler monitoring — which is why serial surveillance is so important in at-risk pregnancies. Dr. Kunda Shahane will provide a realistic assessment of prognosis based on your specific circumstances, including gestational age at detection, severity of anaemia, and presence or absence of hydrops.
What is the risk to the baby from each transfusion?
The procedure-related risk per transfusion session is approximately 1–2% at experienced centres. This includes the risk of fetal distress during the procedure, cord haematoma, infection, and preterm labour. For a baby with severe anaemia, however, the risk of not transfusing is far greater — untreated severe anaemia is almost uniformly fatal or results in severe disability from hydrops. The risk-benefit balance strongly favours treatment in all cases where IUT is recommended. Dr. Kunda Shahane discusses the specific risk in your situation at each decision point.

Related Services at Mayflower Clinic

Cordocentesis → MCA Doppler Scan → High-Risk Pregnancy → All Fetal Therapy Procedures → Genetic Counselling → About Dr. Kunda Shahane →

Your Baby Cannot Wait. Neither Should You.

If you have been diagnosed with Rh disease, parvovirus B19 infection, or elevated MCA Doppler, time matters. Dr. Kunda Shahane is the only specialist in Central India performing intrauterine fetal blood transfusion. Contact us immediately — we prioritise urgent referrals.

📞 Call 0712-669-2706 💬 WhatsApp Urgently 📅 Book Urgent Appointment

Mayflower Fetal Medicine Centre · Dhantoli, Nagpur 440012 · Monday–Saturday 10:00 AM – 6:00 PM · Emergency WhatsApp 24×7

⚖️ PCPNDT Act Compliance Notice Mayflower Fetal Medicine Centre strictly complies with the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994. Sex determination and sex-selective practices are strictly prohibited and punishable by law. All diagnostic services at this centre are performed exclusively for medical diagnosis and fetal wellbeing. Disclosure of fetal sex is illegal and is not performed at this centre.
Medical Disclaimer: This content is for general information only and does not constitute medical advice. Please consult Dr. Kunda Shahane or your treating obstetrician for advice specific to your pregnancy.