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Risks of funipuncture in fetuses with single umbilical arteries
W Sepulveda1, V Dezerega, E Carstens
1Fetal Medicine Center, Department of Obstetrics and Gynecology, Clinica Las Condes, Santiago, Chile. waldosep@chilesat.net
Objective:
To estimate procedure-related risks of funipuncture in fetuses with single umbilical arteries (UAs).
Methods:
We identified fetuses that had blood samples collected by funipuncture and in which single UAs were detected, prenatally or postnatally. We also recorded maternal demographics, prenatal sonographic findings, gestational age at the time of the procedure, procedure-related complications, and perinatal outcomes.
Results:
Over 2 years, 14 fetuses identified as having single UAs had funipuncture for prenatal karyotyping at a median gestational age of 29 weeks (range 20-34 weeks). Each had additional abnormal prenatal sonographic findings. The approach to the cord was transplacental in six cases and transamniotic in eight. There were no failed procedures, and 13 of 14 funipunctures were successful on the first attempt. Three fetuses (21%) had complications (bradycardia in two cases and bleeding in one case), a complication rate not greater than that reported in large series of fetuses that had fetal blood sampling. All three complications were associated with the transamniotic approach. There were no procedure-related pregnancy losses within 2 weeks of the procedure in this series.
Conclusion:
Funipuncture does not seem to be associated with increased risk of procedure-related complications or pregnancy losses in fetuses with single UAs, although the risk could be greater with transamniotic than with transplacental sampling.