ABSTRACT
Fifty years ago, hemolytic disease of the newborn was one of the most common causes of perinatal mortality. Early delivery and neonatal exchange transfusions were the only treatment options, until in the 1960s, intrauterine transfusion became possible. Freda and colleagues performed open fetal surgery, transfusing the fetus using a vein in the exteriorized leg (1,2). A major breakthrough was the development of percutaneous intraperitoneal transfusion under X-ray guidance by Sir William Liley (3). However, hydropic fetuses did not take up the transfused blood from the peritoneal cavity very well. In addition, the technique was not feasible before 27 weeks’ gestation (4). In the 1980s, Sir Charles Rodeck introduced the technique of intravascular transfusion by needling the umbilical artery under direct fetoscopic guidance (5). Shortly afterwards, Jens Bang in Denmark and Fernand Daffos in France both pioneered fetal blood sampling under ultrasound guidance. In the last two decades, their approach is still used worldwide as the technique for intrauterine transfusions (6,7).
