Fetal intestinal obstruction: necessity for percutaneous umbilical blood sampling to assess the severity of Rh sensitization.

Investigation into the severity of hemolytic disease due to Rh isoimmunization may be complicated by concurrent amniotic fluid contamination with bile. We have presented a case in which a prenatal sonogram showed evidence of fetal intestinal obstruction, which was subsequently confirmed postpartum by exploratory laparotomy. Since intrauterine regurgitation of bile occurs with intestinal obstruction distal to the papilla of Vater, percutaneous umbilical blood sampling is necessary to discern the presence and severity of hemolytic disease as indicated by an abnormal spectrophotometric absorption pattern.