Chandigarh, May 28
Pioneering a rare medical procedure involving transfusion of blood into the veins of a foetus, the Army Medical Corps (AMC) has rekindled hope for Rh-isoimmunised women to achieve motherhood. Foetal blood transfusion is a delicate and tricky process that involves inserting a 15-cm-long needle into the umbilical vein of the umbilical cord inside the womb through ultrasound guidance.

A foetal therapy centre has now been set up at the Command Hospital, Chandimandir, which is among the half a dozen centres, including civilian clinics cross the country. This centre has over the past few months of its existence, helped save 24 foetus from sure death. Since foetal transfusion was introduced in the AMC, as many as 116 foetuses have been “salvaged” through 225 instances of transfusion. The vast majority of these cases were handled by a single doctor.

“Rh-isoimmunisation occurs when an Rh-negative woman married to a Rh-positive person and carries an Rh-positive baby. The mother forms Rh-antibodies against Rh-positive cells that cross over into the foetus and start destroying its Rh-positive blood cells, thereby leading to severe anaemia and ultimately death,” explained Col Devendra Arora, a gynaecologist at the hospital who has pioneered this procedure in the armed forces.

There are two methods of transfusion, the easier way being inserting a needle in the foetus’ abdomen, but then its not sure whether blood would reach the veins. The other, which we are using, is directly infusing blood in the foetus’ veins through the umbilical cord (intra-vascular), Col Arora said. The sole Army doctor performing this procedure, he has recently trained another Army doctor to perform this procedure. This procedure has been performed on a foetus as small as 18 weeks. At this stage, a foetus is just about four inches and weighs about 150 gm.

The hospital Commandant, Major-General AD Mathur said that transfusing blood into such a small foetus inside a womb is an extremely difficult and delicate task that requires intense and specialised training. Stating that the AMC holds the national record in intra-vascular transfusion, he added that the Command Hospital ha now been recognised as the national referral centre for the entire armed forces. The hospital is expected to shortly start a training programme in this procedure for other doctors.