Effect of diagnostic and therapeutic cordocentesis on maternal serum alpha-fetoprotein concentration.
We investigated the affect of cordocentesis (n = 36) and intravascular transfusion (n = 14) performed with a fixed needle guide on maternal serum alpha-fetoprotein levels. In 50% of the procedures, the placenta was anterior and punctured. For all patients, maternal serum alpha-fetoprotein levels rose 70.8% +/- 28%. The magnitude of the rise was unrelated to the number of attempts necessary, gestational age, or the initial maternal serum alpha-fetoprotein levels concentration. The location of the placenta was the sole identified variable related to the rise. A total of 44% of the patients had a significant increase in maternal serum alpha-fetoprotein level when the placenta was anterior. In contrast, only 4% of the patients had a significant rise in maternal serum alpha-fetoprotein level when the placenta was other than anterior. There was no difference in the frequency of a significant rise in maternal serum alpha-fetoprotein level concentration between the patients who underwent cordocentesis and those who underwent intravascular transfusion. On the basis of these findings, we recommend that when maternal isoimmunization is a potential concern and the placenta is anterior, the umbilical cord should be approached either through a window or laterally from the placenta.
Weiner
C
C
Department of Obstetrics and Gynecology, University of Iowa School of Medicine, Iowa City 52242.
Grant
S
S
Hudson
J
J
Williamson
R
R
Wenstrom
K
K
D000649:Amniocentesis / Q000009:adverse effects; D001800:Blood Specimen Collection / Q000009:adverse effects*; D005260:Female; D005312:Fetal Blood; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D011897:Random Allocation; D000509:alpha-Fetoproteins / Q000032:analysis*
D000509:alpha-Fetoproteins