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[Complications of cordocentesis associated with fetal therapy]
J A Bournazeau1, B Aublet-Cuvellier, J Raiga
1Maternité, Hôtel-Dieu, Clermont-Ferrand.
Objectives:
To evaluate the technical and obstetrical risk factors of percutaneous umbilical blood sampling (PUBS) when associated with simultaneous fetal therapy.
Study Design:
Retrospective study. One thousand PUBS have been performed in our department between 1984 and 1992. One hundred and forty one of them were done with another invasive fetal procedure. Technical and obstetrical circumstances were related to pregnancy follow-up and complications.
Results:
Pregnancy complication rate increased when PUBS was associated with another invasive procedure (fetal losses: 12.9%, premature rupture of membranes (PROM): 11.6%). No chorioamnionitis nor perinatal infection was observed. As expected, previous fetal status was a main risk factor. Significant relationships have been found between fetal loss risk and therapy procedures such as amnioinfusion and severe IUGR and as well as abnormal post operative fetal tracing. The duration of cord bleeding after needle retrieval was the single risk factor pointed out for PROM.
Conclusion:
The study of the predictors of fetal complications is necessary to separate the genuine risk of previous fetal status and the risk of the invasive procedure itself.