KNH Completes One-Of-A-Kind Operation On 25-Week-Old Baby

Medics at the Kenyatta National Hospital (KNH) in Nairobi on Monday, July 31 celebrated yet another milestone in foetal medicine after they successfully transfused a baby while still in the mother's uterus.

According to a press release, the highly delicate procedure, known as the Intrauterine Fetal Transfusion, was undertaken by a team of four doctors at the national hospital.

They included specialists Dr Rosa Chemwey, Dr Flavia Ogutu, and Dr Ikol Adung'o, as well as Dr Kunjira Murayi (Interventional Radiologist).

They were assisted by Nurses Benson Nyankuru, and Redempata Mumo, as well as a reproductive Health Clinical Officer, Tony Wainaina.

KNH explained that an intrauterine transfusion is a procedure in which red blood cells from a donor are injected into the fetus. Intrauterine transfusion may be recommended when a fetus has anaemia (low red blood cell count).

Using ultrasound to determine the position of the fetus and placenta, the surgeon inserts a needle into the mother's abdomen and then into the umbilical vein or the fetus' abdomen.

Red blood cells that are compatible with the fetus' blood type are passed through the needle into the fetus. Fetal transfusions may need to be repeated every few weeks until the fetus is ready to be born.

The mother is given antibiotics, local anaesthesia, and IV sedation, which also sedates the fetus. The fetus may be given additional medication to stop movement.

According to Dr Chemwey, out of the four pregnancies, the mother only had one successful delivery.

"The mother only has one baby, the last two died of a blood complication known as hemolytic disease of the newborn," she said while referring to the disease where a baby's red blood cells break down quickly.

"We are indeed very determined to ensure this particular pregnancy succeeds. We hope for positive outcomes. This baby is 25 weeks, three days old," said Dr Chemwey.

She added that the baby had severe anaemia because the baby was 'rhesus alloimmunized' a situation in pregnancy when the maternal red blood cells (RBCs) lacking the rhesus antigen are exposed to rhesus-positive red blood cells through the placenta leading to the activation of the maternal immune system.

"So the mum's antibodies destroy the baby's blood, which then develops into anaemia over time," she went on.

According to the specialists, the transfusion procedure takes between 30 minutes to an hour.

"We transfused between 80-100mls of packed red cells. This blood is special as it is O~ negative Leucoreduced, hemoconcentrated, CMV negative, and irradiated to make it very safe for the baby,' she said.

KNH Chief Executive Officer Dr Evanson Kamuri hailed the hospital's team for another milestone, commenting that "This is foetal medicine and an institutional landmark. We have attained yet another achievement in fulfilling our mandate as a top premier referral hospital."

"I'd like to thank the team of doctors and those assisting them for the splendid work done. This confirms that we have the very best medics here at KNH."

An illustration of a fetus in the womb. /SHUTTERSTOCK