THE EFFECT OF DIAGNOSTIC AND THERAPEUTIC CORDOCENTESIS FOR RHESUS HEMOLYTIC-DISEASE ON DOPPLER FLOW VELOCITY

Objective: To investigate the influence of cordocentesis with or witho ut blood transfusion on umbilical and fetal blood flow characteristics . Methods: Of 42 pregnant women suffering from Rh. incompatibility 15 had a puncture of the umbilical cord for diagnostic reasons only. In 2 7 cases a total of 86 punctures was done for blood transfusion. Fetal heart rate, umbilical artery A/B Ratio and Pulsatility Index (PI) in t he fetal aorta were measured before and after cordocentesis in all cas es having or having not a transfusion. Results: Diagnostic and therape utic cordocentesis resulted in a slight decrease of peripheral resista nce. Significant differences were only observed in cases with a haemat ocrit <20% compared to cases with values >40% or if the final haematoc rit after transfusion resulted in a value of <30%. Conclusion: The dec rease peripheral resistance in cases of therapeutic cordocentesis can be attributed to the increase in blood volume and sufficient oxygenati on of blood improving fetal perfusion. Doppler sonography is not helpf ul in the clinical management of red blood cell immunisation.