An unborn baby with a blood disorder has received a transfusion while still in the womb at the Kenyatta National Hospital (KNH), in what the hospital describes as a complicated and significant milestone.
Four doctors, Dr Rosa Chemwey, Dr Flavia Ogutu, Dr Ikol Adung'o and Dr Kunjira Murayi (Interventional Radiologist) performed the clinical procedure known as Intrauterine Foetal Transfusion.
They were assisted by nurses Benson Nyankuru, Redempta Mumo and a reproductive health clinical officer, Tony Wainaina.
KNH reveals that the mother whose baby underwent the complicated procedure had previously lost two children to blood-related complications known as haemolytic disease of the newborn.
This is a condition in which a baby's red blood cells break down rapidly.
Dr Chemwey said that of the mother's four pregnancies, only one had been successful.
"We are determined that this particular pregnancy will be a success. We are hoping for a positive outcome. This baby is 25 weeks and three days old," said Dr Chemwey.
Doctors at KNH discovered that the baby had severe anaemia due to rhesus alloimmunisation.
Low red blood cell count
An unborn baby who needs this procedure is given it if it has anaemia or a low red blood cell count.
The doctors then search for matching red blood cells that will suit the baby without causing further complications.
After obtaining red blood cells that match the foetus' blood type, the doctors carefully transfuse red blood cells from a donor into the unborn baby.
The doctors then use ultrasound to check the position of the foetus and the mother's placenta to avoid any medical errors.
When the baby and mother are ready for the procedure, a surgeon inserts a needle into the mother's abdomen and then into the umbilical vein or the baby's abdomen.
This is not a one-off procedure and may need to be done every few weeks until the mother is carrying the baby.
During this time, the mother is given antibiotics, local anaesthetic and intravenous sedation, which also sedates the foetus.
The baby is sometimes given additional medication to stabilise it during the procedure.
This is a situation in pregnancy where the mother's red blood cells, which lack the rhesus antigen, are exposed to rhesus-positive red blood cells across the placenta, leading to activation of the mother's immune system.
As a result, the mother's antibodies destroy the baby's blood, making it anaemic.
Doctors say the transfusion process takes between 30 minutes and an hour.
"We transfused between 80 and 100 millilitres of packed red blood cells. This blood is special because it is O-negative leucoreduced, haemoconcentrated, CMV negative and irradiated to make it very safe for the baby," said Dr Chemwey.
Kenyatta National Hospital Chief Executive Officer Dr Evanson Kamuri commended the team for a job well done.
"This is fetal medicine and an institutional milestone. We have achieved another success in fulfilling our mandate as a premier referral hospital," he said in a statement.