FETAL DUCTUS VENOSUS FLOW VELOCITY WAVE-FORMS AND MATERNAL SERUM AFP BEFORE AND AFTER FIRST-TRIMESTER TRANSABDOMINAL CHORIONIC VILLUS SAMPLING

Doppler flow velocity waveform recording in the fetal ductus venosus a nd umbilical artery as well as maternal blood sampling for serum alpha -fetoprotein (MSAFP) was performed before and after transabdominal cho rion villus sampling (TACVS) in 36 women of advanced maternal age (gre ater than or equal to 36 years). Gestational age ranged between 11 and 13 weeks. No chromosomal anomaly was detected. No statistically signi ficant difference was observed in ductus venosus velocity parameters o r in the umbilical artery pulsatility index (PI) before and after CVS in 35 women with a normal pregnancy outcome. One case resulted in feta l loss. Post-CVS median MSAFP levels at 12 weeks (25 kIU/l) and 13 wee ks (35 kIU/l) were significantly higher than pre-CVS levels. In three cases, post-CVS MSAFP levels were higher than 600 kIU/l, correlating w ith fete-maternal transfusions of approximately 1.0-1.4 mi, i.e., of a round 40 per cent of fete-placental blood volume. One of these cases d isplayed absence of fetal peripheral blood flow velocities and fetal b radycardia following TACVS, resulting in fetal loss 1 week later. The remaining two cases had a normal pregnancy outcome, but showed a more than 50 per cent reduction in ductus venosus velocity after TACVS, whe reas umbilical artery PI remained unchanged. However, similar velocity changes were associated with only small fete-maternal transfusions. U mbilical artery PI values remained unchanged.