American Journal of Obstetrics & Gynecology
Volume 198, Issue 4 , Pages 387.e1-387.e6, April 2008

Intrahepatic vein for fetal blood sampling: one center’s experience

Presented at the 24th Annual Meeting of the Society for Maternal-Fetal Medicine, New Orleans, LA, Feb. 2-7, 2004.

Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, the Johns Hopkins University School of Medicine, Baltimore, MD.

Received 6 June 2007; received in revised form 1 August 2007; accepted 25 October 2007. published online 21 January 2008.

Objective

The objective of the study was to examine 1 center’s experience with fetal blood sampling via the fetal intrahepatic vein (IHV) and cordocentesis.

Study Design

Consecutive IHV and cordocentesis procedures between July 1987 and February 2006 were compared with respect to success rates, streaming at the sampling site, nonreassuring fetal heart rate (NRFHR), or need for urgent delivery post procedure. A subanalysis of cases with fetal thrombocytopenia was performed. Data were analyzed using Fisher’s exact and Student t tests.

Results

Two hundred ten procedures (130 IHV samplings and 110 cordocenteses) were identified. Success rates were significantly higher with IHV sampling than with cordocentesis (84.6% vs 69.1%, P = .004). Streaming from the sampling site occurred after 0.79% of IHV procedures vs 30.8% of cordocenteses (P < .0001). There was no difference between IHV and cordocentesis in the incidence of NRFHR or need for immediate delivery. Twenty-five cases of fetal thrombocytopenia (20 sampled via IHV, 5 by cordocentesis) were identified. Streaming from the sampling site occurred in 0 of 20 IHV cases vs 2 of 5 cordocentesis cases (40%) (P = .03).

Conclusion

IHV has a significantly lower rate of streaming from the sampling site, compared with cordocentesis. Our data suggest that IHV sampling conveys a particular advantage when fetal thrombocytopenia is suspected.

Key words: cordocentesis, fetal blood sampling, fetal transfusions, intrahepatic vein sampling

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 Cite this article as: Aina-Mumuney AJ, Holcroft CJ, Blakemore KJ, et al. Intrahepatic vein for fetal blood sampling: one center’s experience. Am J Obstet Gynecol 2008;198:387.e1-387.e6.

 Reprints not available from the authors.

PII: S0002-9378(07)02050-9

doi:10.1016/j.ajog.2007.10.806

American Journal of Obstetrics & Gynecology
Volume 198, Issue 4 , Pages 387.e1-387.e6, April 2008

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