Fetal Anemia: Non-Invasive Diagnosis and Monitoring - Yale Medicine Explains

For more information on fetal anemia or #YaleMedicine, visit: https://www.yalemedicine.org/conditio....

Transcript:
Fetal anemia occurs when there aren’t enough red blood cells in a fetus. The red blood cells transport oxygen throughout the body. The red blood cells carry the oxygen to the tissue, and as they unload, they have to go and just reload and come back. Reload and come back. However, if the number of the red blood cells are scarce or low, then it would be an anemia. Then the demand of oxygen might not be met. In the fetal life, that oxygenation happens at the level of placenta.

Your doctor might suggest testing for fetal anemia during pregnancy if you have a positive antibody test or other risk factors. The fetal anemia can be caused by multiple reasons. If there is an incompatibility between the pregnant person's blood type and the fetuses of blood type, inevitably would lead to an immune response to develop within the pregnant person. And those antibodies aren't able to be transferred through the placenta to go to the fetus and destroy those red blood cells. In order to compensate for the need of oxygen, the fetal heart starts working faster and harder, and at some point the heart would get tired. Then it would not pump and the blood would back up. Then that would be just before a fetal demise.

Experts at Yale developed a non-invasive method to diagnose and monitor fetal anemia. In the past, the diagnosis was done invasively. However, in Yale, to show that we could predict the level of anemia through the speed of the blood in the brain, which is called middle cerebral artery doppler, and today we monitor our patients with that. If we see that the anemia is in the severe range, then we can do blood transfusion. If we suspect anemia very early in pregnancy, we can give the blood into the abdominal cavity of the baby where it gets slowly absorbed into the fetal system. However, later, about after 16, 17 weeks, the size of the cord gets large enough that we can insert a needle reliably and repeatedly and sample and deliver the blood as much as it is needed. After birth., the anemia generally resolves.

What we believe and I practice is the human touch. We do not leave our patients alone. We spend time and effort to be with them throughout their journey. These procedures are available through multiple centers, but what is really different is the personal touch being next to the patient, being with them through the diagnosis and through the prenatal care and the delivery and the transitions. Treatment is the easiest part. The feeling that they are not alone is the most important thing.