Fetal Blood Sampling: Review

Öz

Cordocentesis, or percutaneous umbilical blood sampling PUBS allowing direct access to fetal circulation, was first described in 1983 by Daffos et al, who pioneered the procedure for use in evaluation of perinatal toxoplasmosis infection. The technique was quickly adopted and used for diagnosis of many other conditions. Notably this led to a revolutionary change in the approach to the diagnosis and management of isoimmunization. Other common indications for the procedure included rapid karyotype evaluation when fetal abnormalities were detected; evaluation of fetal growth restriction; evaluation of fetal platelet abnormalities eg, maternal immune thrombocytopenic purpura, fetal alloimmune thrombocytopenia, TAR sequence ; evaluation of fetal hydrops; evaluation of potential fetal infections; and evaluation of fetal hemoglobin in patients at genetic risk for hemoglobinopathies. The complications of this procedure can be summarized as fetal bradycardia, chorioamnionitis, premature rupture of membranes and premature onset of labor, fetal exsanguination, fetal distress, abruptio placenta, air embolism and umbilical cord hematoma leading to fetal death.

Anahtar Kelimeler

• Fetal blood sampling,cordocentesis,prenatal diagnosis

Fetal Kan Örneklemesi: Derleme

Öz

Fetal kan örneklemesi ilk olarak perinatal toksoplazmozis olgusunu değerlendirmek için Daffos tarafından 1983 yılında tarif edilmiştir. Teknik hızla kabul görmüş ve birçok başka endikasyonla da kullanılmaya başlanmıştır. Özellikle izoimmünizasyonun tanı ve tedavisinde devrim niteliğinde bir gelişime neden olmuştur. Diğer yaygın endikasyonları ise fetal anomlali tespit edildiğinde hızlı karyotip değerlendirmesi, gelişme gerilkiklerinin değerlendirilmesi, fetal trombosit anomalilerinin değerlendirilmesi maternal immün trombositopenik purpura, fetal alloimmün trombositopeni, TAR sekansı gibi , fetal hidropsun değerlendirilmesi, potansiyel fetal infeksiyonların değerlendirilmesi ve genetik risk altındaki fetuslarda fetal hemoglobinopatilerin değerlendirilmesidir. Komplikasyonları arasında fetal bradikardi, koriyoamniyonit, erken membran rüptürü ve preterm travay, fetal kanama, fetal distres ve kordonda hematom oluşumuna bağlı fetal ölüm, ablasyo plasenta ve hava embolisi yer almaktadır.

Anahtar Kelimeler

• Fetal kan örneklemesi,kordosentez,prenatal tanı

Kaynakça

1. Society for Maternal-Fetal Medicine (SMFM), Berry SM, Stone J, et al. Fetal blood sampling. Am J Obstet Gynecol 2013; 209:170.
2. Mouw RJ, Klumper F, Hermans J, et al. Effect of atracurium or pancuro- nium on the anemic fetus during and directly after intravascular intraute- rine transfusion. A double blind randomized study. Acta Obstet Gynecol Scand 1999; 78:763.
3. Weiner CP, Okamura K. Diagnostic fetal blood sampling-technique related losses. Fetal Diagn Ther 1996; 11:169.
4. Bovicelli L, Orsini LF, Grannum PA, et al. A new funipuncture technique: two-needle ultrasound- and needle biopsy-guided procedure. Obstet Gy- necol 1989; 73:428.
5. Welch CR, Talbert DG, Warwick RM, et al. Needle modifications for inva- sive fetal procedures. Obstet Gynecol 1995; 85:113.
6. Boupaijit K, Wanapirak C, Piyamongkol W, et al. Effect of placenta penet- ration during cordocentesis at mid-pregnancy on fetal outcomes. Prenat Diagn 2012; 32:83.
7. Weiner CP. Cordocentesis for diagnostic indications: two years’ experien- ce. Obstet Gynecol 1987; 70:664.
8. Weiner CP, Wenstrom KD, Sipes SL, Williamson RA. Risk factors for cordocentesis and fetal intravascular transfusion. Am J Obstet Gynecol 1991; 165:1020.

9. Nicolini U, Nicolaidis P, Fisk NM, et al. Fetal blood sampling from the intrahepatic vein: analysis of safety and clinical experience with 214 pro- cedures. Obstet Gynecol 1990; 76:47.
10. Aina-Mumuney AJ, Holcroft CJ, Blakemore KJ, et al. Intrahepatic vein for fetal blood sampling: one center’s experience. Am J Obstet Gynecol 2008; 198:387.
11. Chinnaiya A, Venkat A, Dawn C, et al. Intrahepatic vein fetal blood samp- ling: current role in prenatal diagnosis. J Obstet Gynaecol Res 1998; 24:239.
12. Antsaklis AI, Papantoniou NE, Mesogitis SA, et al. Cardiocentesis: an alternative method of fetal blood sampling for the prenatal diagnosis of hemoglobinopathies. Obstet Gynecol 1992; 79:630.
13. Westgren M, Selbing A, Stangenberg M. Fetal intracardiac transfusions in patients with severe rhesus isoimmunisation. Br Med J (Clin Res Ed) 1988; 296:885.
14. Nicolaides KH, Clewell WH, Rodeck CH. Measurement of human fetop- lacental blood volume in erythroblastosis fetalis. Am J Obstet Gynecol 1987; 157:50.
15. Forestier F, Cox WL, Daffos F, Rainaut M. The assessment of fetal blood samples. Am J Obstet Gynecol 1988; 158:1184.
16. Ogur G, Gül D, Ozen S, et al. Application of the ‘Apt test’ in prenatal diagnosis to evaluate the fetal origin of blood obtained by cordocentesis: results of 30 pregnancies. Prenat Diagn 1997; 17:879.
17. Sepulveda W, Be C, Youlton R, et al. Accuracy of the haemoglobin al- kaline denaturation test for detecting maternal blood contamination of fetal blood samples for prenatal karyotyping. Prenat Diagn 1999; 19:927.
18. Lazebnik N, Hendrix PV, Ashmead GG, et al. Detection of fetal blood con- tamination by amniotic fluid obtained during cordocentesis. Am J Obstet Gynecol 1990; 163:78.
19. Chao A, Herd JP, Tabsh KM. The ferning test for detection of amniotic fluid contamination in umbilical blood samples. Am J Obstet Gynecol 1990; 162:1207.
20. Orlandi F, Damiani G, Jakil C, et al. The risks of early cordocentesis (12- 21 weeks): analysis of 500 procedures. Prenat Diagn 1990; 10:425.
21. Daffos F, Forestier F, Kaplan C, Cox W. Prenatal diagnosis and mana- gement of bleeding disorders with fetal blood sampling. Am J Obstet Gynecol 1988; 158:939.
22. Paidas MJ, Berkowitz RL, Lynch L, et al. Alloimmune thrombocytopenia: fetal and neonatal losses related to cordocentesis. Am J Obstet Gynecol 1995; 172:475.
23. Gruel Y, Boizard B, Daffos F, et al. Determination of platelet antigens and glycoproteins in the human fetus. Blood 1986; 68:488.
24. Takashima T, Maeda H, Koyanagi T, et al. Prenatal diagnosis and obstet- rical management of May-Hegglin anomaly: a case report. Fetal Diagn Ther 1992; 7:186.
25. Lorenz P, Bollmann R, Hinkel GK, et al. False-negative prenatal exclusion of Wiskott-Aldrich syndrome by measurement of fetal platelet count and size. Prenat Diagn 1991; 11:819.
26. Ash KM, Mibashan RS, Nicolaides KH. Diagnosis and treatment of fe- to-maternal hemorrhage in a fetus with homozygous von Willebrand’s disease. Fetal Ther 1988; 3:189.
27. Bussel, J. Minutes of the Neonatal Subcommittee of the International Committee of Thrombosis and Hemostasis Working Party on Neonatal Alloimmune Thrombocytopenia, Brussels, Belgium, 1987.
28. Hogge WA, Thiagarajah S, Brenbridge AN, Harbert GM. Fetal evaluation by percutaneous blood sampling. Am J Obstet Gynecol 1988; 158:132.
29. Jauniaux E, Donner C, Simon P, et al. Pathologic aspects of the umbilical cord after percutaneous umbilical blood sampling. Obstet Gynecol 1989; 73:215.
30. Chénard E, Bastide A, Fraser WD. Umbilical cord hematoma following diagnostic funipuncture. Obstet Gynecol 1990; 76:994.
31. Nicolini U, Kochenour NK, Greco P, et al. Consequences of fetomaternal haemorrhage after intrauterine transfusion. BMJ 1988; 297:1379.
32. Weiner C, Grant S, Hudson J, et al. Effect of diagnostic and therapeutic cordocentesis on maternal serum alpha-fetoprotein concentration. Am J Obstet Gynecol 1989; 161:706.
33. Chitrit Y, Caubel P, Lusina D, et al. Detection and measurement of fetoma- ternal hemorrhage following diagnostic cordocentesis. Fetal Diagn Ther 1998; 13:253.
34. Boulot P, Deschamps F, Lefort G, et al. Pure fetal blood samples obtained by cordocentesis: technical aspects of 322 cases. Prenat Diagn 1990; 10:93.
35. Ludomirsky A, Weiner S, Ashmead GG, et al. Percutaneous fetal um- bilical blood sampling: procedure safety and normal fetal hematologic indices. Am J Perinatol 1988; 5:264.
36. Maxwell DJ, Johnson P, Hurley P, et al. Fetal blood sampling and preg- nancy loss in relation to indication. Br J Obstet Gynaecol 1991; 98:892.
37. Ghidini A, Sepulveda W, Lockwood CJ, Romero R. Complications of fetal blood sampling. Am J Obstet Gynecol 1993; 168:1339.
38. Tongsong T, Wanapirak C, Kunavikatikul C, et al. Fetal loss rate associ- ated with cordocentesis at midgestation. Am J Obstet Gynecol 2001; 184:719.
39. Antsaklis A, Daskalakis G, Papantoniou N, Michalas S. Fetal blood samp- ling--indication-related losses. Prenat Diagn 1998; 18:934.
40. Liao C, Wei J, Li Q, et al. Efficacy and safety of cordocentesis for prenatal diagnosis. Int J Gynaecol Obstet 2006; 93:13.
41. Srisupundit K, Wanapirak C, Piyamongkol W, et al. Comparisons of out- comes after cordocentesis at mid-pregnancy between singleton and twin pregnancies. Prenat Diagn 2011; 31:1066.
42. Patriarco MS, Viechnicki BM, Hutchinson TA, et al. A study on intrauterine fetal resuscitation with terbutaline. Am J Obstet Gynecol 1987; 157:384.
43. Afschar P, Schöll W, Bader A, et al. A prospective randomised trial of atosiban versus hexoprenaline for acute tocolysis and intrauterine resus- citation. BJOG 2004; 111:316.
44. Shalev E, Peleg D. Fetal cardiac resuscitation. Lancet 1993; 341:305.