Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Sigmund-Freud-Strasse 25, Bonn, Germany.
J Perinat Med. 2012 Mar 22;40(4):353-7. doi: 10.1515/jpm-2011-0255.
To investigate fetomaternal hemorrhage (FMH) rate and quantity in the second trimester of pregnancies with fetal anomalies and to assess the impact of invasive prenatal and termination procedures.
Blood samples from women before termination of pregnancy were collected and analyzed by dual-color flow cytometry. Various clinical parameters were studied for their association with FMH.
In total, 67 women were recruited; pre- and post-termination pairs were collected for 31 women. HbF cells were present in 91.0% of specimens, in 29.9% the transfused blood volume was ≥4.2 mL. FMH ≥30 mL was found in 3.0%, and chronic FMH, defined as FMH ≥40% of fetoplacental blood volume in 7.5%. At the limit of quantification (0.1%) none of the clinical parameters was associated with the presence of HbF cells, nor was there a difference in HbF cell concentrations between pre- and post-termination blood samples.
Compared to normal term pregnancy, transfer of fetal red blood cells into the maternal circulation is increased in second-trimester pregnancies with fetal anomalies. FMH is not associated with invasive procedures or surgery performed in the context of termination. We hypothesize that the abnormal pregnancy itself, by means of an abnormal uteroplacental interface, is causing the increased transfer.
研究胎儿畸形孕妇妊娠中期胎儿母血转移（FMH）的发生率和转移量，并评估侵入性产前诊断和终止妊娠手术对其的影响。
采集终止妊娠前孕妇的血样，并采用双色流式细胞术进行分析。研究各种临床参数与 FMH 的相关性。
共招募了 67 名妇女；其中 31 名妇女收集了终止妊娠前和终止妊娠后的配对样本。91.0%的标本中存在 HbF 细胞，29.9%的输入血量≥4.2 毫升。发现 FMH≥30 毫升的有 3.0%，FMH≥40%胎盘中胎儿血液量的慢性 FMH 有 7.5%。在定量限（0.1%）下，没有任何临床参数与 HbF 细胞的存在相关，也没有在终止前和终止后血液样本之间 HbF 细胞浓度的差异。
与正常足月妊娠相比，胎儿畸形孕妇妊娠中期胎儿红细胞向母体循环的转移增加。FMH 与侵入性手术或终止妊娠手术无关。我们假设异常妊娠本身通过异常的胎盘界面导致了转移的增加。
