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Serial fetal blood sampling for the management of pregnancies complicated by severe rhesus (D) isoimmunization
Author(s) -
MacKENZIE I. Z.,
CASTLE B. M.,
SELINGER M.,
FERGUSON J. F.,
BOWELL P. J.
Publication year - 1988
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1988.tb06548.x
Subject(s) - amniocentesis , medicine , fetus , rh isoimmunization , obstetrics , gestation , pregnancy , blood sampling , prenatal diagnosis , biology , genetics
Summary. Fifty‐one pregnancies complicated by rhesus (D) isoimmunization have been managed by serial fetal blood sampling between 17 and 36 weeks gestation as an alternative to amniocentesis for ΔOD 453 measurements. In 36 pregnancies where the fetus was shown to be rhesus (D) positive and both measurements were made before any intrauterine fetal transfusions, the ΔOD 453 value gave misleading predictions on 13 of 63 occasions (21%). Fetal haematocrit estimations provided a direct assessment of the haemopoietic compensation occurring, but fetal bilirubin and albumin concentrations did not correlate directly with disease severity. It is proposed that pregnancies complicated by severe isoimmunization can be more precisely managed by serial fetal blood sampling for haematocrit estimation than amniocentesis for ΔOD 453 measurement thus avoiding unnecessary intervention or delayed treatment.