Assessment of fetomaternal hemorrhage by Kleihauer-Betke test, flow cytometry and alpha-fetoprotein after invasive obstetric procedures

Assessment of fetomaternal hemorrhage by Kleihauer-Betke test, flow cytometry and alpha-fetoprotein after invasive obstetric procedures

Author Meleti, Daniela Autor UNIFESP Google Scholar
Caetano, A. C. R. Autor UNIFESP Google Scholar
Boute, Tatiane Autor UNIFESP Google Scholar
Oliveira, L. G. de Autor UNIFESP Google Scholar
Araujo, E. Autor UNIFESP Google Scholar
Nardozza, Luciano Marcondes Machado Autor UNIFESP Google Scholar
Moron, Antonio Fernandes Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Purpose: The aim of this study was to evaluate the passage of fetal red blood cells to the maternal circulation, after invasive obstetric procedures, through the Kleihauer-Betke test, flow cytometry and by measurement of maternal serum a-fetoprotein level. Methods: This prospective descriptive study with patients submitted to amniocentesis, cordocentesis, chorionic villus sampling (CVS), amnioreduction and ventriculoamniotic shunt was performed for karyotype analysis, treatment of hydrocephalus and polyhydramnios and to assess fetal lung maturity. Maternal blood samples were collected before and 60 minutes after the invasive obstetric procedure to search for fetal erythrocytes using the Kleihauer-Betke test, flow cytometry and serum a-fetoprotein measurement. Results: Ten invasive obstetric procedures were performed. The mean age of the patients was 29.2 years and the mean gestational age was 29.6 weeks. The procedures were: five amniocenteses, two cordocenteses, one CVS, one ventriculo-amniotic shunt and one amnioreduction with cephalocentesis. The indications for the procedures were: karyotype analysis in five patients, fetal lung maturity assessment in two patients, amnioreduction in one patient, fetal hydrocephalus shunt in one patient and polyhydramnios related to hydranencephaly in one patient. Regarding the path of puncture, three procedures were accomplished through the placenta and seven apart from it. All punctures were successful at the first attempt. There was no significant increase of fetal erythrocyte quantity in maternal blood samples using the Kleihauer-Betke test. After cordocentesis, a significant increase of fetal erythrocytes was detected by flow cytometry and serum a-fetoprotein measurement. Conclusion: Invasive obstetric procedures during prenatal care are safe when performed by experienced professionals using adequate techniques, with minimal chance of passage of fetal erythrocytes from the fetal compartment.
Keywords Fetomaternal hemorrhage
Invasive obstetric procedure
Kleihauer-Betke test
Flow cytometry
alpha-fetoprotein
Language English
Date 2012-01-01
Published in Clinical And Experimental Obstetrics & Gynecology. Montreal: I R O G Canada, Inc, v. 39, n. 3, p. 303-306, 2012.
ISSN 0390-6663 (Sherpa/Romeo, impact factor)
Publisher I R O G Canada, Inc
Extent 303-306
Origin http://www.irog.net/download/?magazine=32
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000308510700007
URI http://repositorio.unifesp.br/11600/43295

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