Fetal-maternal bleeding associated with genetic amniocentesis: real-time versus static ultrasound.
The incidence of fetal to maternal bleeding was studied in 773 consecutive patients having genetic amniocentesis by measuring maternal serum alpha-fetoprotein elevation following the procedure. The frequency of fetal to maternal bleeding was significantly lower in patients having amniocentesis immediately after real-time ultrasound (21 of 429 cases, 4.9%) when compared with patients having static B-mode ultrasound before the procedure (31 of 344 cases, 9.0%). A lower frequency of fetal to maternal bleeding was observed in the real-time group for anterior or partially anterior placentas (8.1%) and posterior or fundal posterior placentas (0%) when compared with the static B-mode group (12.9 and 5.2%, respectively). The rate of spontaneous abortion in patients with fetal to maternal bleeding (12.8%) was significantly higher than the rate in patients who did not demonstrate such bleeding (1.45%). The implications of these findings with regard to the safety of amniocentesis and the benefit of routine preliminary ultrasound evaluation are discussed.
D000649:Amniocentesis / Q000009:adverse effects*; D005260:Female; D030342:Genetic Diseases, Inborn / Q000175:diagnosis*; D006801:Humans; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology*; D014465:Ultrasonics / Q000009:adverse effects*; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins