title: Echogenic venous turbulence is a critical feature of successful intravascular intrauterine transfusion.
abstract: Late during the fifth intravascular intrauterine transfusion of a fetus with severe Rh isoimmunization, the loss of visible echogenic turbulence within the umbilical vein during injection preceded the development of unresolving fetal bradycardia. An umbilical cord hematoma was found at the time of emergency cesarean delivery. Although seldom described, echogenic turbulence is an important feature of the successful intravascular intrauterine transfusion, and deserves close surveillance. Disappearance of this visible turbulence suggests loss of proper needle location. Possible sources of needle tip displacement are discussed and preventive measures described.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill.
authors.forename: J W
authors.initials: JW
authors.lastname: Seeds
authors.forename: W A
authors.initials: WA
authors.lastname: Bowes
authors.forename: N C
authors.initials: NC
authors.lastname: Chescheir
mesh_terms: D000328:Adult; D001805:Blood Transfusion, Intrauterine / Q000009:adverse effects*; D001919:Bradycardia / Q000209:etiology; D005260:Female; D006340:Heart Rate, Fetal; D006406:Hematoma / Q000209:etiology; D006801:Humans; D009339:Needles; D011247:Pregnancy; D012203:Rh Isoimmunization / Q000628:therapy*; D014463:Ultrasonography; D014470:Umbilical Cord / Q000473:pathology*; D014471:Umbilical Veins / Q000502:physiology*