Maternal-fetal hemorrhage after amniocentesis and cordocentesis

Abstract

Objective: To compare the frequency and amount of maternal-fetal hemorrhage
following amniocentesis and cordocentesis. Design: Case-control study.
Institución. Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela. Methods:
Pregnant women with singleton pregnancies without fetal anomalies undergoing
amniocentesis for fetal karyotyping (16–20 weeks’ gestation) or cordocentesis (20–
30 weeks’ pregnancy) in the period January 2017-May 2022. Main study outcomes:
General characteristics of the procedure, Kleihauer-Brown-Betke test results, and
maternal serum alpha-fetoprotein concentrations. Results: The study sample was
305 patients. Amniocentesis was performed in 165 women and cordocentesis in 140
cases. De novo maternal-fetal hemorrhage was observed in 8 patients (4.8%) after
amniocentesis and in 41 patients (29.3%) after cordocentesis, de novo maternalfetal
hemorrhage was observed in 8 patients (4.8%). Serum alpha-fetoprotein
concentrations increased in 24 cases (14.5%) after amniocentesis and in 55 cases
(39.3%) after cordocentesis (p < 0.05). After cordocentesis, higher mean maternalfetal
hemorrhage volume, elevation of individual volume values and significant
increases in severe maternal-fetal hemorrhage (more than 5 mL of fetal erythrocytes)
and total fetoplacental blood volume loss were observed (p < 0.05). Conclusion:
These results show that both amniocentesis and cordocentesis increase the risk
of maternal-fetal hemorrhage. However, ultrasound-guided amniocentesis has a
lower risk of producing hemorrhage and resulting Rh isoimmunization compared to
cordocentesis.