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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 2

Category: Fetal Intervention

Poster Session 2

(408) Outcomes of intrauterine transfusion in Hemolytic Disease of the Fetus and Newborn in the US

Wednesday, February 11, 2026
3:30 PM - 5:00 PM  
Objective:
To evaluate complications of intrauterine transfusion (IUT) for the treatment of severe Hemolytic Disease of the Fetus and Newborn (HDFN) in the United States in the last twenty years.

Study Design:
This study was conducted in pregnant individuals age 18 – 49 with commercial insurance in the Merative MarketScan Commercial Claims and Encounters (CCAE) database or government assistance insurance in the Merative MarketScan Multi-State Medicaid (Medicaid) database from 2000 – 2024. Cohorts were defined by an ICD alloimmunization diagnosis code and IUT procedure code and a pregnancy outcome of live or still birth. IUT complications and pregnancy outcomes were compared between databases.

Results:
In CCAE, 234 births (96.6% liveborn) occurred in 230 individuals. On average, each pregnancy underwent 2.5 (SD = 1.7) IUTs with the first occurring at gestational week 28 (SD = 5); 17% were delivered by Cesarean section within one day of an IUT. Maternal infections requiring hospitalization after the start of IUTs occurred in 3.0% of pregnancies. In Medicaid, 180 births (97.2% liveborn) occurred in 168 individuals. Mean number of IUTs (2.4; SD = 1.7), gestational age at first IUT (27 weeks; SD = 6), and deliveries by Cesarean within one day of an IUT (19%) were similar to CCAE, while maternal infections requiring hospitalization occurred more often in Medicaid (11.1%). Prevalence of preterm birth (30.8% CCAE; 31.1% Medicaid) and Cesarean section delivery (61.5% CCAE; 61.7% Medicaid) were higher compared to the general pregnant population (9.8% CCAE, 16.9% Medicaid for preterm birth; 34.6% CCAE, 30.0% Medicaid for Cesarean delivery) while the prevalence of preterm premature rupture of membranes was 2 – 3 times higher in pregnancies with IUTs versus the general pregnant population.

Conclusion:
Although IUTs were performed at a similar gestational age in the two populations, both subsequent infection and Cesarean section rates were higher in the Medicaid population. A higher rate of premature delivery in patients with IUT than in the general pregnant population is a potential additional source of neonatal comorbidity.