Transient iatrogenic heart block following foetal intracardiac transfusion for severe twin anaemia-polycythaemia sequence

Abstract

Abstract Background: Intrauterine blood transfusion is an important treatment of foetal anaemia. Although the standard access to the foetal vasculature for transfusion is the umbilical vein, the intracardiac route is used when foetal or placental positions make other accesses technically challenging. Intrauterine, intracardiac blood transfusion is associated with complications including haemopericardium, damage to cardiac tissues and foetal bradycardia. Highlights of the present report: We report a case of monochorionic twins with twin anaemia-polycythaemia sequence (TAPS). Intracardiac, intrauterine blood transfusion of the donor twin was complicated by haemopericardium and sustained bradycardia which necessitated delivery by emergency caesarean section. Postnatally, the bradycardia was sustained and was diagnosed electrocardiographically as heart block, which spontaneously reversed on the second day after birth. The management of heart block in the neonatal period is discussed. Conclusion: Foetal intracardiac intrauterine blood transfusion can be associated with transient congenital heart block (CHB).