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Percutaneous umbilical blood sampling: current trends and outcomes
Catherine A Bigelow1, Christina M Cinelli2, Sarah E Little1
1Brigham and Women's Hospital, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Harvard Medical School, Boston, MA, United States.
Summary
Percutaneous umbilical blood sampling (PUBS) is a successful procedure with a low complication rate. However, non-immune hydrops fetalis (NIHF) increases complication and intrauterine fetal demise (IUFD) risks, especially with parvovirus.
Area of Science:
- Perinatology
- Maternal-Fetal Medicine
- Fetal Surgery
Background:
- Percutaneous umbilical blood sampling (PUBS) is a key intervention in managing high-risk pregnancies.
- Understanding its indications, success rates, and complications is crucial for patient counseling.
- Hydrops fetalis presents unique challenges in fetal interventions.
Purpose of the Study:
- To evaluate the contemporary experience with PUBS.
- To analyze indications and complications, stratified by the presence of hydrops fetalis.
- To assess outcomes in pregnancies complicated by hydrops fetalis undergoing PUBS.
Main Methods:
- Retrospective review of 455 PUBS procedures performed between 1988 and 2013.
- Data collected included demographics, indications, success rates, and complications.
- Statistical analysis compared outcomes based on hydrops fetalis status and time period.
Main Results:
- PUBS demonstrated a 97.8% success rate with a stable 2.5% procedural complication rate.
- Non-immune hydrops fetalis (NIHF) was associated with the highest complication rates (6.3%) and intrauterine fetal demise (IUFD) risk (31.7%).
- Parvovirus-mediated NIHF had a particularly high IUFD rate (60%).
Conclusions:
- PUBS is a highly successful procedure with a low overall complication rate.
- Pregnancies with NIHF face significantly higher risks of complications and IUFD following PUBS.
- Findings aid in counseling patients regarding PUBS for diagnostic or therapeutic purposes, especially in cases of NIHF.
