Abimbola Aina

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Intrahepatic vein for fetal blood sampling: one center's experience.

Abimbola J Aina-Mumuney; Cynthia J Holcroft; Karin J Blakemore; Jessica L Bienstock; Nancy A Hueppchen; Lorraine A Milio; Jude P Crino (Profiled Authors: Karin Blakemore; Lorraine Milio; Abimbola Aina; Nancy Hueppchen; Jessica Bienstock; Jude Crino)

Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
American journal of obstetrics and gynecology 2008;198(4):387.e1-6.

OBJECTIVE: The objective of the study was to examine 1 center's experience with fetal blood sampling via the fetal intrahepatic vein (IHV) and cordocentesis. STUDY DESIGN: Consecutive IHV and cordocentesis procedures between July 1987 and February 2006 were compared with respect to success rates, streaming at the sampling site, nonreassuring fetal heart rate (NRFHR), or need for urgent delivery post procedure. A subanalysis of cases with fetal thrombocytopenia was performed. Data were analyzed using Fisher's exact and Student t tests. RESULTS: Two hundred ten procedures (130 IHV samplings and 110 cordocenteses) were identified. Success rates were significantly higher with IHV sampling than with cordocentesis (84.6% vs 69.1%, P = .004). Streaming from the sampling site occurred after 0.79% of IHV procedures vs 30.8% of cordocenteses (P < .0001). There was no difference between IHV and cordocentesis in the incidence of NRFHR or need for immediate delivery. Twenty-five cases of fetal thrombocytopenia (20 sampled via IHV, 5 by cordocentesis) were identified. Streaming from the sampling site occurred in 0 of 20 IHV cases vs 2 of 5 cordocentesis cases (40%) (P = .03). CONCLUSION: IHV has a significantly lower rate of streaming from the sampling site, compared with cordocentesis. Our data suggest that IHV sampling conveys a particular advantage when fetal thrombocytopenia is suspected.

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