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Fetal hepatic necrosis following blood sampling from the intrahepatic vein
S N Sturgiss1, C Wright, J M Davison
1Department of Obstetrics and Gynaecology, NE1 4LP, U.K.
Previous reports have suggested that fetal blood sampling from the intrahepatic vein is not associated with significant fetal hepatic injury. We report a case of fetal liver necrosis occurring 24 h following blood sampling from the intrahepatic vein of a fetus with severe growth retardation at 34 weeks. The placenta was in a posterior position, precluding either blood sampling from the placental insertion or placental biopsy. Fetal death occurred in utero within 24 h of the procedure, which was carried out by an experienced operator. At post-mortem the liver appeared normally formed, but the right lobe was diffusely congested, with a well-defined demarcation line between the right and left lobes. Liver histology revealed extensive recent haemorrhagic necrosis of the right lobe.
Previous reports have suggested that fetal blood sampling from the intrahepatic vein is not associated with significant fetal hepatic injury. We report a case of fetal liver necrosis occurring 24 h following blood sampling from the intrahepatic vein of a fetus with severe growth retardation at 34 weeks. The placenta was in a posterior position, precluding either blood sampling from the placental insertion or placental biopsy. Fetal death occurred in utero within 24 h of the procedure, which was carried out by an experienced operator. At post-mortem the liver appeared normally formed, but the right lobe was diffusely congested, with a well-defined demarcation line between the right and left lobes. Liver histology revealed extensive recent haemorrhagic necrosis of the right lobe.