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Revista Peruana de Ginecología y Obstetricia
On-line version ISSN 2304-5132
Abstract
RONDON-TAPIA, Martha et al. Maternal-fetal hemorrhage after amniocentesis and cordocentesis. Rev. peru. ginecol. obstet. [online]. 2022, vol.68, n.4, 00005. Epub Nov 30, 2022. ISSN 2304-5132. http://dx.doi.org/10.31403/rpgo.v68i2450.
Objective
: To compare the frequency and amount of maternal-fetal hemorrhage following amniocentesis and cordocentesis.
Design
: Case-control study. Institución. Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela.
Methods
: Pregnant women with singleton pregnancies without fetal anomalies undergoing amniocentesis for fetal karyotyping (16-20 weeks’ gestation) or cordocentesis (20- 30 weeks’ pregnancy) in the period January 2017-May 2022. Main study outcomes: General characteristics of the procedure, Kleihauer-Brown-Betke test results, and maternal serum alpha-fetoprotein concentrations.
Results
: The study sample was 305 patients. Amniocentesis was performed in 165 women and cordocentesis in 140 cases. De novo maternal-fetal hemorrhage was observed in 8 patients (4.8%) after amniocentesis and in 41 patients (29.3%) after cordocentesis, de novo maternalfetal hemorrhage was observed in 8 patients (4.8%). Serum alpha-fetoprotein concentrations increased in 24 cases (14.5%) after amniocentesis and in 55 cases (39.3%) after cordocentesis (p < 0.05). After cordocentesis, higher mean maternalfetal hemorrhage volume, elevation of individual volume values and significant increases in severe maternal-fetal hemorrhage (more than 5 mL of fetal erythrocytes) and total fetoplacental blood volume loss were observed (p < 0.05).
Conclusion
: These results show that both amniocentesis and cordocentesis increase the risk of maternal-fetal hemorrhage. However, ultrasound-guided amniocentesis has a lower risk of producing hemorrhage and resulting Rh isoimmunization compared to cordocentesis.
Keywords : Hemorrhage; maternal-fetal; Amniocentesis; Cordocentesis; Complications.