Application of transcervical hysterofetoscopy and cord blood collection at first trimester termination of pregnancy for fetal abnormalities.
OBJECTIVE
To examine the applicability of hysterofetoscopy and cord blood collection at first trimester termination of pregnancy for fetal abnormalities.


METHODS
From 2004 to 2007, transcervical hysterofetoscopy was performed in seven patients at the same operation setting of surgical termination of pregnancy. The findings were compared with prenatal diagnosis. Feasibility of cord blood collection was also examined.


RESULTS
Out of these seven patients, six of them had prenatal ultrasound diagnosis of cystic hygroma. All of them had chromosomal abnormalities. Subcutaneous oedema was confirmed by hysterofetoscopy with good view. Another pregnancy was complicated by homozygous alpha thalassaemia and the diagnosis was confirmed by electrophoresis of fetal haemoglobin collected from umbilical cord vessel. Cord blood collection was also attempted in two other patients yielding fetal blood with minimal maternal contamination.


CONCLUSIONS
Transcervical hysterofetoscopy is a feasible tool in confirming external fetal structural abnormalities before surgical termination of pregnancy. It can be performed under either general anaesthesia or conscious sedation. Umbilical cord blood collection can facilitate confirmation of genetic diseases. It may also allow the potential of isolating fetal mesenchymal stem cell in first trimester.
Chan
B C
BC
Department of Obstetrics and Gynaecology, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong. bcpchan@hkucc.hku.hk
Hui
P W
PW
Leung
W C
WC
Leung
K Y
KY
Pun
T C
TC
Lee
C P
CP
D000028:Abortion, Induced; D001800:Blood Specimen Collection / Q000379:methods*; D002869:Chromosome Aberrations; D005260:Female; D005312:Fetal Blood; D005332:Fetoscopy / Q000379:methods*; D005333:Fetus / Q000002:abnormalities*; D005865:Gestational Age; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D018191:Lymphangioma, Cystic / Q000175:diagnosis / Q000196:embryology; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis / Q000379:methods; D016216:Ultrasonography, Prenatal