Feto-maternal transfusion after chorionic villus sampling: clinical implications

Brambati, B.; Guercilena, S; Bonacchi, I.; Oldrini, A.; Lanzani, A.; Piceni, L.

doi:10.1093/oxfordjournals.humrep.a136340

Cited by 51 publications

(25 citation statements)

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“…The data reported by Fuhrmann et al [15] suggested a correlation between the AFP increase and the frequency of spontaneous abortion following CVS in the group with an AFP increase of more than 100% or with continuing rise in the first hour following CVS. No such correlation was found by Brambati et al [3].…”

Section: Discussionmentioning

confidence: 74%

Fetomaternal Transfusion and Pregnancy Outcome after Cordocentesis

Sikovanyecz¹,

Horváth

Sallay

et al. 2001

Fetal Diagn Ther

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Objective: To study the extent of fetomaternal transfusion and the outcome of pregnancy after cordocentesis. Material and Methods: 268 women underwent percutaneous fetal umbilical cord blood sampling for fetal karyotyping between 15 and 26 gestations of weeks. Complete follow-up was available in 221 (82.5%) of the cases. Cordocentesis was performed under continuous real-time ultrasound guidance. The duration of the procedure and the post-procedural bleeding time was counted in seconds. Fetomaternal transfusion was calculated by using the measurements of the maternal serum levels of α-fetoprotein before and after the procedure. The data were analyzed by Student’s t and multiple regression tests. Results: The maximum and mean amounts of fetomaternal transfusion were 1.067 and 0.061 ml, respectively. Twenty percent or more α-fetoprotein elevation was in 35.4% of the cases. Positive correlation was found between bleeding time after cordocentesis and fetomaternal transfusion (r = 0.174, p < 0.0129) as well as between the duration of the procedure (r = 0.165, p < 0.0171) and the amount of fetomaternal transfusion. Comparing the cordocentesis at the placental insertion site and at the free cord loop, a smaller amount of fetomaternal transfusion was observed (p < 0.0123) in the latter. Transplacental passage was associated with a higher amount of fetomaternal transfusion (p < 0.0067). No association was found between the extent of fetomaternal transfusion and the outcome of pregnancy. The fetal loss related to the cordocentesis was 0.50%. Conclusions: The extent of fetomaternal transfusion was influenced by the subsequent four parameters: procedural time, bleeding time, puncture site and transplacental penetration. The lack of the association between the degree of fetomaternal transfusion and the outcome of pregnancy, along with the low (0.50%) post-procedural fetal loss rate, suggest that cordocentesis is clinically a safe procedure.

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Section: Discussionmentioning

confidence: 74%

Fetomaternal Transfusion and Pregnancy Outcome after Cordocentesis

Sikovanyecz¹,

Horváth

Sallay

et al. 2001

Fetal Diagn Ther

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“…For that reason, a noninvasive determination of fetal RHD genotype can be a useful tool for all sensitized women, reducing the iatrogenic risk of increasing maternal sensitization due to chorionic villus sampling (CVS) or amniocentesis. Additionally, in isoimmunized women requiring invasive testing for prenatal diagnosis of chromosomal defects or genetic abnormalities, knowledge of the fetal RHD genotype would be useful in deciding whether to conduct first trimester CVS because of the risk of feto‐maternal hemorrhage, and therefore worsening of the severity of alloimmunization and fetal hemolysis would be higher than with second trimester amniocentesis (Brambati et al , 1986; Tabor et al , 1987). In the case of women with no RhD hemolytic antibodies, knowledge that the fetus is RHD negative is useful in determining the need for prenatal and postnatal immunoprophylaxis with anti‐D.…”

Section: Introductionmentioning

confidence: 99%

Fetal RHD genotype detection from circulating cell‐free fetal DNA in maternal plasma in non‐sensitized RhD negative women

Bombard¹,

Akolekar²,

Farkas³

et al. 2011

Prenatal Diagnosis

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Objective To examine the performance of the SensiGene Fetal RHD Genotyping Laboratory Developed Test (RHD Genotyping LDT) using circulating cell-free fetal DNA (ccff DNA) extracted from maternal plasma.Methods ccff DNA was extracted from maternal blood from non-sensitized women with singleton pregnancies in two cohorts, one with a serotype reference (11-13 weeks' gestation) and one with the reference source (6-30 weeks' gestation). The presence of three RHD exon sequences (exons 4, 5, 7), the psi-pseudogene, three Y-chromosome sequences (SRY, DBY and TTTY2), and the X/Y-chromosome TGIF gene control were determined using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry-the RHD Genotyping LDT. ResultsThe cohort with a serotype RhD reference showed correct classification in 201 of 207 patients, a test accuracy of 97.1%, with a sensitivity and specificity for prediction of RhD serotype of 97.2 and 96.8%, respectively. The cohort with a genotype RHD reference showed correct classification in 198 of 199 patients, indicating a test accuracy of 99.5% with a sensitivity and specificity for prediction of RHD genotype of 100.0 and 98.3%, respectively. ConclusionFetal RHD genotyping can accurately be determined using ccff DNA in the first and second trimesters of pregnancy.

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“…Chorionic villus sampling (CVS), an invasive intrauterine procedure for first-trimester prenatal diagnosis, may induce fetomaternal hemorrhage (FMH), leading to complications such as red cell and platelet immunization (Blakemore et al, 1986;Brambati et al, 1986;Fuhrmann et al, 1988;Moise and Carpenter, 1990;ACOG Practice Bulletin, 1999;Lee et al, 1999). Even very small volumes of Rh-positive blood may result in antibody formation in Rh-negative individuals (Jakobowicz et al, 1972).…”

Section: Introductionmentioning

confidence: 99%