Indications of 1342 fetal cord blood sampling procedures performed as an integral part of high risk pregnancy care.
BACKGROUND
Fetal umbilical cord blood sampling is now being performed worldwide, using an ultrasound guided technique, for prenatal diagnosis in pregnancies at high risk for several congenital and genetic defects in the fetus. Awareness of feasibility of the procedure and indications for the same should be known to every obstetrician.


OBJECTIVE
To study the indications for Fetal Cord Blood Sampling in high risk pregnancy patients in the last 20 years at a tertiary referral center in India.


METHODS
Women referred to the Fetal Medicine Clinic for fetal blood sampling from January 1990 to November 2009, were assessed. An informed consent was taken. Under continuous ultrasound guidance, a 22 gauge long spinal needle was inserted through the maternal abdomen and uterine wall into the umbilical cord, and about 2-4 ml of blood, depending on the indication was aspirated by syringe. The various indications for fetal blood sampling in 1342 women were analyzed.


RESULTS
Cord blood sampling was performed for the following indications: Hb in Rh Isoimmunized pregnancies-553 cases, Chromosomal analysis-427 cases, non-immune hydrops/pleural effusion/ascites-cases 88, Congenital Infections-131 cases, Intrauterine Growth Restriction-51 cases, Thalassemia-53 cases, Hemophilia-36 cases, and for Thyroid function test for fetal goiter in 3 cases, in total 1,342 women.


CONCLUSIONS
There were several absolute indications for fetal cord blood sampling in high risk pregnant women, to provide state-of-the-art information on the health of the fetus. Awareness of the procedure and indications for the same should be known to every obstetrician as it is technically feasible, expertise is available in India; so that women who require the procedure may be referred in time.
Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, Room No 3073, 3rd Floor Teaching Block, Ansari Nagar, New Delhi, 110029 India.
Deepika
D
Deka
Vatsla
V
Dadhwal
Kumar Kallol
KK
Roy
Neena
N
Malhotra
Arvind
A
Vaid
Suneeta
S
Mittal
Cord blood sampling; Indication; Ultrasound