Blood product replacement in the perinatal period.
OBJECTIVE
In this article, we will describe some of the special compatibility testing procedures and blood component preparation and modification techniques used in intrauterine and neonatal transfusion medicine. We also will review the transfusion therapy used in hemolytic disease of the fetus and newborn (HDFN) and fetal and neonatal alloimmune thrombocytopenia (FNAIT).


RESULTS
Transfusion therapy in the fetus and neonate requires blood typing and compatibility testing techniques not routinely used for adults. These include: cord blood testing, special attention to the volume and speed of infusion, cytomegalovirus risk reduction, and routine irradiation of cellular blood components. The treatment of HDFN and FNAIT involves phenotyping and/or genotyping of fetal and paternal red blood cells and platelets. In FNAIT, platelet products are chosen based on the absence of platelet-specific antigens.


CONCLUSIONS
Fetal and neonatal transfusion medicine require special attention to the unique anatomic and physiologic features of early human development.
Wu
YanYun
Y
Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT 06504, USA. yan.wu@yale.edu
Stack
Gary
G
D016913:Blood Component Transfusion; D001805:Blood Transfusion, Intrauterine; D004899:Erythroblastosis, Fetal / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005315:Fetal Diseases / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D013921:Thrombocytopenia / Q000628:therapy*