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Fetomaternal hemorrhage in the second trimester
-
Waltraut M. Merz
,
Franziska Patzwaldt
Veröffentlicht/Copyright:
22. März 2012
Abstract
Aims: To investigate fetomaternal hemorrhage (FMH) rate and quantity in the second trimester of pregnancies with fetal anomalies and to assess the impact of invasive prenatal and termination procedures.
Methods: Blood samples from women before termination of pregnancy were collected and analyzed by dual-color flow cytometry. Various clinical parameters were studied for their association with FMH.
Results: In total, 67 women were recruited; pre- and post-termination pairs were collected for 31 women. HbF cells were present in 91.0% of specimens, in 29.9% the transfused blood volume was ≥4.2 mL. FMH ≥30 mL was found in 3.0%, and chronic FMH, defined as FMH ≥40% of fetoplacental blood volume in 7.5%. At the limit of quantification (0.1%) none of the clinical parameters was associated with the presence of HbF cells, nor was there a difference in HbF cell concentrations between pre- and post-termination blood samples.
Conclusions: Compared to normal term pregnancy, transfer of fetal red blood cells into the maternal circulation is increased in second-trimester pregnancies with fetal anomalies. FMH is not associated with invasive procedures or surgery performed in the context of termination. We hypothesize that the abnormal pregnancy itself, by means of an abnormal uteroplacental interface, is causing the increased transfer.
Keywords: Fetal malformation; fetomaternal hemorrhage; flow cytometry; Kleihauer Betke test; prenatal diagnosis; Rh alloimmunization; termination of pregnancy
Received: 2011-10-10
Revised: 2012-1-30
Accepted: 2012-2-27
Published Online: 2012-03-22
Published in Print: 2012-06-01
©2012 by Walter de Gruyter Berlin Boston
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Schlagwörter für diesen Artikel
Fetal malformation;
fetomaternal hemorrhage;
flow cytometry;
Kleihauer Betke test;
prenatal diagnosis;
Rh alloimmunization;
termination of pregnancy
Artikel in diesem Heft
- Masthead
- Masthead
- Review Article
- Noninvasive prenatal diagnosis of Down syndrome: current knowledge and novel insights
- Original Articles – Obstetrics
- Midtrimester amniotic fluid concentrations of interleukin-6 and interferon-gamma-inducible protein-10: evidence for heterogeneity of intra-amniotic inflammation and associations with spontaneous early (<32 weeks) and late (>32 weeks) preterm delivery
- An evolutionary test of the isoform switching hypothesis of functional progesterone withdrawal for parturition: humans have a weaker repressive effect of PR-A than mice
- Fetomaternal hemorrhage in the second trimester
- Contribution of 3D power Doppler ultrasound to the evaluation of placental circulation in normal pregnancies and pregnancies complicated by preeclampsia
- Two vs. three or more primary recurrent pregnancy losses – are there any differences in epidemiologic characteristics and index pregnancy outcome?
- Oxidative stress stimulates α-tocopherol transfer protein in human trophoblast tumor cells BeWo
- Risk factors for preeclampsia in twin pregnancies: a population-based matched case-control study
- Bishop score and cervical length at 33–35 weeks of gestation and the risk of intrapartum cesarean delivery of twins
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