This list shows commonly used medications for intrauterine transfusions (IUT), a brief reasoning for use, and common dosages. This is not intended to be a list of the only medications available or a list of must-use medications. Providers must determine which medications are used when. Copied with permission from Intrauterine Fetal Transfusion of Red Cells.
Medications for the mother
48 hours before procedure
A course of anetnatal corticosteroids for lung development in case of emergency c-section.
30 minutes before procedure
2 grams Ancef (Cefazolin) – OR – 1-2 grams of another first generation cephalosporin as a prophylactic antibiotic within one hour of the start of the procedure to prevent infection.
20 minutes before procedure
0.25 mg subcutaneous Terbutaline to prevent contractions.
Immediately before the procedure
2 mg Versed – OR – 1-2 mg of Midazolam – OR- 25-50 mcg intravenous Fentanyl for maternal sedation to reduce anxiety.
During the procedure
Remifentanil infusion can be used in the operating room and monitored by an anesthesiologist for maternal sedation. It can be easily titrated to the desired effect due to its short half-life.
0.25% Marcaine for local anesthesia.
Medications for the fetus
After the first fetal blood sample has been drawn
2 mcg/kg estimated fetal weight by ultrasound of fentanyl for fetal sedation.
0.1 mg/kg fetal weight vecuronium – OR – 0.4 mg/kg EFW atracurium besylate for fetal paralysis.