Detection of fetomaternal haemorrhage associated with cordocentesis using serum α‐fetoprotein and the kleihauer technique

Selm, Maria Van; Kanhai, Humphrey H.H.; Loon, A.J. van

doi:10.1002/pd.1970150403

Cited by 30 publications

(20 citation statements)

References 16 publications

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“…Some authors [5,6] have suggested that maternal ·-fetoprotein determination was more sensitive than the Kleihauer technique in the diagnostic of FMH following amniocentesis while other authors [3,4] have regarded these as two equivalent techniques. Similarly, the results of a previous study [13] have demonstrated that both techniques were comparable in the detection of FMH after cordocentesis. Consequently, the authors have considered the Kleihauer technique to be a reliable indicator of FMH following FBS.…”

Section: Discussionsupporting

confidence: 58%

“…In five studies, FMH after FBS procedures was assessed by simultaneous combination of the Kleihauer technique and maternal ·-fetoprotein levels [3][4][5][6]13]. Some authors [5,6] have suggested that maternal ·-fetoprotein determination was more sensitive than the Kleihauer technique in the diagnostic of FMH following amniocentesis while other authors [3,4] have regarded these as two equivalent techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Fetomaternal hemorrhage (FMH) has been investigated after amniocentesis [1][2][3][4][5][6][7][8][9], fetoscopy and placentesis [10,11] and also after cordocentesis [12][13][14]. Fetomaternal bleeding following fetal sampling techniques is not rare and has been currently detected by either maternal serum ·-fetoprotein measurement, or the Kleihauer-Betke staining technique.…”

Section: Introductionmentioning

confidence: 99%

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Detection and Measurement of Fetomaternal Hemorrhage following Diagnostic Cordocentesis

Chitrit

Caubel²,

Lusina³

et al. 1998

Fetal Diagn Ther

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Objective: The aim of this study was to investigate the effect of cordocentesis on fetomaternal hemorrhage (FMH). Methods: One hundred and three diagnostic cordocenteses, without any other associated procedure, were performed at 23–40 weeks’ gestation. FMH was detected using the Kleihauer-Betke staining of maternal blood taken immediately before and after cordocentesis. Results: Significant FMH occurred after 40 (38.8%) of the 103 procedures. An increased risk of fetal bleeding was associated with both an anterior placenta (odds ratio (OR) 5.89; 95% confidence interval (CI) 2.27–15.3; p < 0.001) and a transplacental cordocentesis (OR 37.0; 95% CI 2.15–636; p < 0.001). The volume of FMH was greater after cordocentesis with an anterior placenta (90th percentile 6.20 ml) than after cordocentesis with a lateral (90th percentile 4.58 ml) or posterior placenta (90th percentile 1.35 ml) (p < 0.001). After fetal blood sampling, significant FMH occurred more frequently with a procedure duration of 3 min or more (OR 4.45; 95% CI 1.70–11.7; p = 0.002) and with two or more needle insertions (OR 4.65; 95% CI 1.80–12.1; p = 0.001). Conclusion: FMH following cordocentesis may be related to placental injuries. This event is influenced by placental location, procedure duration and the number of needle insertions.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Detection and Measurement of Fetomaternal Hemorrhage following Diagnostic Cordocentesis

Chitrit

Caubel²,

Lusina³

et al. 1998

Fetal Diagn Ther

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“…According to Young et al [13] the 'occurrence of either grossly or microscopically bloody samples is statistically more common if the placenta is anteriorly located rather than posteriorly located'. Van Selm et al [10] reported an association between the anterior location of the placenta and FMT during cordocentesis. The anterior location of the placenta was found to be a risk factor for FMT after cordocentesis, and these results were confirmed by Buscaglia et al [4] with an additional observation that longer procedural time was followed by higher AFP level increase.…”

Section: Discussionmentioning

confidence: 99%

“…According to Van Selm et al [10] the detection of FMT by using the AFP measurements and Kleihauer technique before and after cordocentesis in the second trimester of pregnancy are comparable, while in the third trimester the Kleihauer technique is more sensitive. In this second trimester study we applied the maternal serum AFP level measurement.…”

Section: Discussionmentioning

confidence: 99%

Fetomaternal Transfusion and Pregnancy Outcome after Cordocentesis

Sikovanyecz¹,

Horváth

Sallay

et al. 2001

Fetal Diagn Ther

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Objective: To study the extent of fetomaternal transfusion and the outcome of pregnancy after cordocentesis. Material and Methods: 268 women underwent percutaneous fetal umbilical cord blood sampling for fetal karyotyping between 15 and 26 gestations of weeks. Complete follow-up was available in 221 (82.5%) of the cases. Cordocentesis was performed under continuous real-time ultrasound guidance. The duration of the procedure and the post-procedural bleeding time was counted in seconds. Fetomaternal transfusion was calculated by using the measurements of the maternal serum levels of α-fetoprotein before and after the procedure. The data were analyzed by Student’s t and multiple regression tests. Results: The maximum and mean amounts of fetomaternal transfusion were 1.067 and 0.061 ml, respectively. Twenty percent or more α-fetoprotein elevation was in 35.4% of the cases. Positive correlation was found between bleeding time after cordocentesis and fetomaternal transfusion (r = 0.174, p < 0.0129) as well as between the duration of the procedure (r = 0.165, p < 0.0171) and the amount of fetomaternal transfusion. Comparing the cordocentesis at the placental insertion site and at the free cord loop, a smaller amount of fetomaternal transfusion was observed (p < 0.0123) in the latter. Transplacental passage was associated with a higher amount of fetomaternal transfusion (p < 0.0067). No association was found between the extent of fetomaternal transfusion and the outcome of pregnancy. The fetal loss related to the cordocentesis was 0.50%. Conclusions: The extent of fetomaternal transfusion was influenced by the subsequent four parameters: procedural time, bleeding time, puncture site and transplacental penetration. The lack of the association between the degree of fetomaternal transfusion and the outcome of pregnancy, along with the low (0.50%) post-procedural fetal loss rate, suggest that cordocentesis is clinically a safe procedure.

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LETTER TO THE EDITOR. Alpha‐fetoprotein Elevation in Maternal Serum after Percutaneous Umbilical Blood Sampling (PUBS)

1996

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Detection of fetomaternal haemorrhage associated with cordocentesis using serum α‐fetoprotein and the kleihauer technique

Cited by 30 publications

References 16 publications

Detection and Measurement of Fetomaternal Hemorrhage following Diagnostic Cordocentesis

Detection and Measurement of Fetomaternal Hemorrhage following Diagnostic Cordocentesis

Fetomaternal Transfusion and Pregnancy Outcome after Cordocentesis

LETTER TO THE EDITOR. Alpha‐fetoprotein Elevation in Maternal Serum after Percutaneous Umbilical Blood Sampling (PUBS)

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