DETECTION AND MEASUREMENT OF FETOMATERNAL HEMORRHAGE FOLLOWING DIAGNOSTIC CORDOCENTESIS

Objective: The aim of this study was to investigate the effect of cord ocentesis on fetomaternal hemorrhage (FMH). Methods: One hundred and t hree diagnostic cordocenteses, without any other associated procedure, were performed at 23-40 weeks' gestation. FMH was detected using the Kleihauer-Betke staining of maternal blood taken immediately before an d after cordocentesis. Results: Significant FMH occurred after 40 (38. 8%) of the 103 procedures. An increased risk of fetal bleeding was ass ociated with both an anterior placenta (odds ratio (OR) 5.89; 95% conf idence interval (CI) 2.27-15.3; p < 0.001) and a transplacental cordoc entesis (OR 37.0; 95% CI 2.15-636; p < 0.001). The volume of FMH was g reater after cordocentesis with an anterior placenta (90th percentile 6.20 mi) than after cordocentesis with a lateral (90th percentile 4.58 mi:) or posterior placenta (90th percentile 1.35 mi) (p < 0.001). Aft er fetal blood sampling, significant FMH occurred more frequently with a procedure duration of 3 min or more (OR 4.45; 95% CI 1.70-11.7; p = 0.002) and with two or more needle insertions (OR 4.65; 95% CI 1.80-1 2.1; p = 0.001). Conclusion: FMH following cordocentesis may be relate d to placental injuries. This event is influenced by placental locatio n, procedure duration and the number of needle insertions.