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The Importance of Placental Localization Preceding Amniocentesis

From the Departments of Obstetrics and Gynecology, Radiology, and Internal Medicine, University of Iowa Hospitals, Iowa City, Iowa.

Abstract

Fetal-maternal microtransfusion complicating transabdominal amniocentesis has been studied in 28 patients who underwent a total of 39 amniocenteses. The numbers of fetal cells in maternal venous blood were counted before and after each tap and the placenta was localized by the B-scan ultrasound technic; these data were not revealed until the patient had delivered. Although significant numbers of fetal cells were found before the first amniocentesis in 5 patients, and fetal cells increased after an amniocentesis that could not have traversed the posterior placenta of 1 patient, 50% of those women with an anterior placenta that was penetrated by the needle had a remarkable increase in fetal erythrocytes. The threat of a significant microtransfusion in an Rh-negative unsensitized woman warrants efforts to localize and thereby avoid the placenta when amniocentesis is indicated.