IN 1963, LILEY reported the first successful intrauterine transfusion of a fetus with severe erythroblastosis fetalis.1 Instillation of Rh-negative erythrocytes into the fetal peritoneal cavity enabled the fetus to survive long enough to permit a preterm viable delivery.
The patient was a 32-year-old woman with a history of intrauterine transfusions done at 32 weeks and one day, and again at 33 weeks and four days. An amniogram outlined the placenta and showed no evidence of fetal edema. Five hours later, premedication was administered and the patient was transferred to the x-ray department. Paper clips were placed at sites on the maternal abdomen estimated to correspond to the fetal peritoneal cavity as determined roentgenographically by swallowed radiopaque medium. With the patient under local anesthesia, an 8-cm Touhy needle was inserted into the amniotic cavity and the stylet was withdrawn. Sterile saline was injected through the needle as it was advanced