Invasive testing for the karyotyping of mid-trimester intrauterine fetal death (IUFD): a pilot study.
BACKGROUND
Aneuploidy remains a common cause of fetal loss after the first trimester. Conventional karyotyping from fetal solid tissues post-delivery unfortunately has a poor success rate particularly where the fetus is macerated. To overcome this we obtained amniocentesis and/or chorionic villus samples from mid-trimester intrauterine fetal deaths (IUFDs) prior to medical termination of pregnancy.


METHODS
Ten women with diagnosed IUFD between 12 and 24 weeks' gestation underwent amniocentesis and/or CVS performed after counselling.


RESULTS
Successful karyotypes were obtained in all pregnancies. Five of the ten pregnancies were complicated by aneuploidy (two with trisomy 21, two with trisomy 18, and one with trisomy 13).


CONCLUSIONS
The high rate of aneuploidy (50%) in this small cohort emphasises the need for karyotyping. A successful karyotype in all ten pregnancies demonstrates the value of offering these procedures before a termination of pregnancy. We would recommend the adoption of this approach in the management of IUFD occurring after the first trimester.
Howarth
E S
ES
Department of Obstetrics and Gynaecology, University of Leicester, Leicester Royal Infirmary, Leicester, UK.
Konje
J C
JC
Healey
K A
KA
Duckett
D P
DP
Scudamore
I W
IW
Taylor
D J
DJ
D000293:Adolescent; D000328:Adult; D000649:Amniocentesis; D015193:Chorionic Villi Sampling; D002882:Chromosomes, Human, Pair 13; D002887:Chromosomes, Human, Pair 18; D004314:Down Syndrome / Q000235:genetics; D005260:Female; D005313:Fetal Death / Q000235:genetics*; D005865:Gestational Age; D006801:Humans; D007621:Karyotyping / Q000379:methods*; D010865:Pilot Projects; D011247:Pregnancy; D014314:Trisomy