Maternal-fetal hemorrhage after amniocentesis and cordocentesis

• Autores: Rondón-Tapía, Martha, Torres-Cepeda, Duly, Mejia-Montilla, Jorly, Reyna-Villasmil, Nadia, Fernández-Ramírez, Andreina, La Rotta-Nuñez, Elisabeth, Reyna-Villasmil, Eduardo
• Formato: artículo
• Fecha de Publicación: 2022
• Institución: Sociedad Peruana de Obstetricia y Ginecología
• Repositorio: Revista Peruana de Ginecología y Obstetricia
• Lenguaje: español; inglés
• OAI Identifier: oai:ginecologiayobstetricia.pe:article/2450
• Enlace del recurso: https://ginecologiayobstetricia.pe/index.php/RPGO/article/view/2450
• Nivel de acceso: acceso abierto
• Materia: Hemorragia; materno-fetal; Amniocentesis; Cordocentesis; Complicaciones; Hemorrhage; maternal-fetal; Complications

Objective: To compare the frequency and amount of maternal-fetal hemorrhagefollowing amniocentesis and cordocentesis. Design: Case-control study.Institución. Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela. Methods:Pregnant women with singleton pregnancies without fetal anomalies undergoingamniocentesis for fetal karyotyping (16–20 weeks’ gestation) or cordocentesis (20–30 weeks’ pregnancy) in the period January 2017-May 2022. Main study outcomes:General characteristics of the procedure, Kleihauer-Brown-Betke test results, andmaternal serum alpha-fetoprotein concentrations. Results: The study sample was305 patients. Amniocentesis was performed in 165 women and cordocentesis in 140cases. De novo maternal-fetal hemorrhage was observed in 8 patients (4.8%) afteramniocentesis and in 41 patients (29.3%) after cordocentesis, de novo maternalfetalhemorrhage was observed in 8 patients (4.8%). Serum alpha-fetoproteinconcentrations increased in 24 cases (14.5%) after amniocentesis and in 55 cases(39.3%) after cordocentesis (p < 0.05). After cordocentesis, higher mean maternalfetalhemorrhage volume, elevation of individual volume values and significantincreases in severe maternal-fetal hemorrhage (more than 5 mL of fetal erythrocytes)and total fetoplacental blood volume loss were observed (p < 0.05). Conclusion:These results show that both amniocentesis and cordocentesis increase the riskof maternal-fetal hemorrhage. However, ultrasound-guided amniocentesis has alower risk of producing hemorrhage and resulting Rh isoimmunization compared tocordocentesis.