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Fetal blood sampling and pregnancy loss in relation to indication

1991; Wiley; Volume: 98; Issue: 9 Linguagem: Inglês

10.1111/j.1471-0528.1991.tb13511.x

1471-0528

D. J. Maxwell, Pam Johnson, Pauline Hurley, K. Neales, Lindsey D. Allan, Peter Knott,

Pregnancy and preeclampsia studies

Abstract Objective— To assess the relation between the indication for fetal blood sampling and pregnancy loss following the procedure. Design— Retrospective study. Setting— The tertiary referral Fetal Medicine Units at Guy's and University College Hospitals, London. Subjects— Women undergoing diagnostic fetal blood sampling in four groups: (1) 94 having prenatal diagnosis with normal ultrasound findings; (2) 94 with a structural fetal abnormality; (3) 30 having fetal assessment and (4) 35 with non‐immune hydrops. Interventions— Freehand ultrasound guided fetal blood sampling from umbilical cord, intrahepatic vein or fetal heart. Main outcome measures— Pregnancy losses were divided into those within 2 weeks and those 2 weeks after the procedure, obstetric accidents and neonatal deaths. Results— The 253 patients had fetal blood sampled on 268 occasions. Fifty‐one pregnancies were terminated. Overall, 51 of the remaining 202 desired continuing pregnancies were lost, of which 19 (9%) were lost within 2 weeks of the procedure. After exclusion of the pregnancies that were terminated, the procedure‐related losses within 2 weeks of sampling were 1 in 76 (1%), 5 in 76 (7%), 4 in 29 (14%) and 9 in 36 (25%) in groups 1, 2, 3 and 4 respectively. Conclusions— The risk of fetal blood sampling is increased in abnormal pregnancies, reflecting the underlying pathology and this must be taken into account when counselling patients before the procedure.