Fetal blood sampling and pregnancy loss in relation to indication

Article Abstract:

Fetal blood can be sampled with the guidance of ultrasonography, the use of sound waves to visualize the fetus. Testing of fetal blood samples is used to detect certain genetic disorders. However, fetal blood sampling from the umbilical cord has been associated with an increased risk of miscarriage. If miscarriage occurs within 24 hours of fetal blood sampling, pregnancy loss is considered to be related to the procedure. However, the relation between fetal blood sampling and miscarriage becomes less clear with increased time between blood sampling and pregnancy loss, particularly in pregnancies with defects in the structure, metabolism, or genes of the fetus. The relation between ultrasound guided fetal blood sampling and miscarriage was assessed in 94 pregnancies with normal ultrasound findings, 94 pregnancies with abnormalities in the structure of the fetus, 30 women who underwent fetal assessment, and 35 women with pregnancies affected by nonimmune hydrops, or tissue fluid accumulation in the fetus. Fetal blood was obtained from the umbilical cord, a blood vessel in the fetal liver, or the fetal heart. Of 253 pregnancies, there were 51 abortions and 51 miscarriages, including 19 that occurred within two weeks of fetal blood sampling. The largest number of procedure-related miscarriages occurred among women with nonimmune hydrops, followed by those who underwent fetal assessment, and pregnancies affected by fetal structural defects. These findings suggest that the risk of miscarriage following fetal blood sampling is increased in patients with abnormal pregnancies. Patients should be made aware of such risks before undergoing this procedure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Complications and side effects, Fetal blood, Prenatal diagnosis

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Partial placenta menbranacea

Article Abstract:

Placenta menbranacea is a rare disorder of the placenta in which placental tissue does not develop separately from the fetus but, rather, grows over the fetal membranes. It is associated with miscarriage and hemorrhage during the second trimester of pregnancy. A description is presented of seven cases of partial placenta membranacea that occurred in one hospital in England. Hemorrhage occurred in all cases during the second or third trimester, leading to significant blood loss in five cases. In six cases, miscarriage resulted. After delivery of the infant in the seventh case, hemorrhage occurred; in this case and one other, the placenta remained in the uterus until hemorrhage. The condition did not appear to be associated with maternal age, number of previous children borne, smoking habits, or the type of contraceptive used. Abnormalities of the placenta or uterus were noted using ultrasound in five pregnancies. Chorioamnionitis (inflammation of placental tissue) was present in five cases. No significant abnormalities in the liveborn or miscarried fetuses were seen. Placenta membranacea, while rare (one estimate is that it occurs in 1 pregnancy out of every 21,500), is important because of its consequences. The cases described showed partial placenta membranacea, in which only some of the fetal membranes are covered by placental tissue. It is possible that this condition is the cause of recurrent hemorrhage during the second trimester of pregnancy in some cases. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Hemorrhage, Placental diseases, Placenta diseases

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Unusual splenic sinusoidal iron overload in sickle cell/haemoglobin D-Punjab disease

Article Abstract:

A report on an eleven year old boy with sickle cell/haemoglobin D-Punjab disease, treated with regular transfusions from infancy, who underwent splenectomy at the age of ten for hypersplenism is given. This highlights the fact that although transfusion programmes ameliorate the symptoms of sickle cell disease, the dangers of iron overload should always be remembered.

United States, Science & research, Research, Case studies, Sickle cell anemia, Splenectomy

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