Posted on 04/26/2002 7:07:08 AM PDT by Former Fetus
Tiny Miracle: Unborn Child Receives Rare Blood Transfusion
Sacramento, CA -- Isaac James Melendez is so young he doesn't even have an age yet; he won't be born until July 21 or so.
According to the ultrasound pictures, he's a strapping little fellow. And listen to his wonderfully strong and regular heartbeat as picked up and amplified by ultrasound equipment: "VROOM VROOM VROOM VROOM VROOM."
Robust as he is, he was on the ultrasound screen at Kaiser Sacramento Medical Center the other day for an emergency procedure to save his life.
Isaac's mother, Audrey Melendez, has Rh-negative blood and Isaac is Rh-positive. Antibodies in her blood against the Rh factor are killing off Isaac's red blood cells. He was anemic and getting more so by the day.
That's where Dr. Colleen Hendershott came in. Using steady hands and a needle the length of a bicycle spoke, she pricked a vein in the umbilical cord and drew off some of the baby's blood to replace it with donated Rh-negative blood that will not be affected by the antibodies.
Melendez, 35, was lying sedated but awake on her back, covered, except for her abdomen, in green surgical drapes. At her left hand stood her husband, Anthony, 39.
And by her left hip stood Hendershott. At her right hip was the ultrasound technician and the ultrasound machine.
The doctor and the technician pushed and massaged the mother's soft tummy as they watched the ultrasound image on the monitor, rotating Isaac until he was in just the right position.
"Is the blood here yet?" someone asked, and as if on cue a gowned worker entered with a little plastic bag of specially prepared blood that was promptly hung from a hook above Melendez's right foot.
Then Hendershott went to work with her needle straight into the mother's abdomen, making tiny movements with her gloved right hand to push the probe ever deeper.
All the while she peered into the screen of the ultrasound monitor, where the image was magnified greatly as a ghostly line intersecting the ghostly cord like a grainy underwater video shot. Then, with everything connected, the blood was pumped in, several samples were collected and all the piping and machinery was unhooked with great economy of motion.
Hendershott, 39, said afterward that she learned the procedure during her fellowship at the Los Angeles County-University of Southern California Medical Center, where such cases are not uncommon.
"I'll do maybe two of these a year now for all the Kaiser hospitals in Northern California," she said. "But there, where there were always women who'd had no prenatal care, the procedure was much more common," she said.
The condition can occur with women in their second and later pregnancies, after an Rh-positive baby triggers the immune response, she said. Medicine is used to prevent the reactions, but occasional cases such as Melendez's occur despite the best of care, Hendershott added.
As for performing the intrauterine transfusion, she has an operating room team of five who know their many jobs cold, and the whole hospital snaps to attention when one of the procedures is done.
"But the blood center people are the key, of course, and they know their stuff," she said.
In Isaac's case, Hendershott needed about a half-pint of O-negative blood, but it had to meet a host of other rigid standards as well, said Dr. Chris Gresens, associate medical director at BloodSource, formerly the Sacramento Blood Center.
"Most important is the donor, and we have several donors who can give blood for fetal transplants," he said. Donors cannot have been infected ever with CMV -- cytomegalovirus -- a common disease that can prove fatal to the very young.
Even though blood can be kept for up to 42 days and still be used, fetal transplant blood must be no more than 5 days old, Gresens said.
"And then we have hands-on work by 10 to 12 different people -- everything from filtering the white cells from the unit to screening for sickle-cell trait," Gresens said.
Being the donor in such a case shouldn't make much difference, but it does, said Kendra Kelly, 27, a donor since her days in high school in the Glenn County farm town of Corning and now an employee of BloodSource.
Identities of donors are not revealed, and the donor in Isaac's case will remain a secret, but Kelly said she has O-negative and CMV-negative blood, so her blood is sought for such infant and fetal transfusions.
"And it makes you feel kind of good to know they're depending on you. You'll hear other donors who are CMV-negative who'll mention they're 'baby donors' when they come in," she said.
Since the symptoms of CMV infection resemble mononucleosis, I would suggest that you check with your son's physician.
My son is 41 years old. His physician probably wouldn't talk to me about his health, and his wife would probably be offended! :) But I'll mention this program. I know he gets called from time to time to donate. He's been donating since he was 18, first through our church and later when a friend of his was badly burned in an accident.
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