Invasive testing for the karyotyping of mid‐trimester intrauterine fetal death (IUFD): a pilot study

Abstract

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.

A comparison of prenatal versus postnatal karyotyping for the investigation of intrauterine fetal death after the first trimester of pregnancy

“…In fact, the successful rate from skin biopsies from IUFDs during this study period was only 13.5%, which is comparable to that reported by Rodgers et al (1996). Although in our pilot of 10 cases (Howarth et al, 2002), karyotyping was successful in all the cases, we believe that the success rates reported in this larger series best reflect our contemporary practice and should be provided to parents during counselling. In a series by Kyle et al (1996), the postmortem sampling failure rate for skin and placenta was 24%.…”

“…Each woman was counselled prior to the procedure (either amniocentesis or CVS or both) by one of three consultants or the maternal-fetal medicine trainee. The procedures were undertaken as previously described (Howarth et al, 2002). Where there was either oligohydramnios or anhydramnios, the procedure of choice was CVS.…”

“…This is much lower than the success rate of 99% from routine amniocentesis and chorionic villus sampling (CVS) for prenatal diagnosis. It was on this basis that we piloted invasive testing for IUFD in our unit prior to the induction of delivery, and the results from the first 10 patients have been published (Howarth et al, 2002). Following the success of the pilot, we extended the testing and in addition, compared it to routine karyotyping from solid tissues for the management of IUFD in our unit.…”

Amniocentesis for karyotyping prior to induction of abortion at second trimester

“…Within most units in the Western countries, karyotyping of a dead fetus has typically been performed on fetal tissue samples obtained after delivery. However, with fetal tissue, there is a relatively high rate of postdelivery cell culture failure due to autolysis or contamination (Rodgers et al, (Saal et al, 1987;Howarth et al, 2002), we consider amniocentesis for karyotyping prior to induction of labor. Karyotyping for all of our four cases was successfully performed at second trimester.…”