Use of atracurium besylate to arrest fetal activity during intrauterine intravascular transfusions

Prevention of movement during intrauterine transfusion is important to facilitate the procedure and to prevent injury to the fetus. We administered atracurium besylate to the fetus via the umbilical vein during 12 intrauterine intravascular transfusions. A dose of 0.2-0.4 mg/kg of estimated fetal weight was administered after needle entry into the umbilical vein. With a dose of 0.2 mg/kg, fetal movement was slowed transiently. Thereafter, 0.4 mg/kg was administered. All recipients were paralyzed for the duration of the procedure. Fetal activity returned 20-130 minutes later.