Fetal Blood Sampling (FBS) for Rh Sensitization During Pregnancy
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Fetal blood sampling (FBS) is the collecting of fetal blood
directly from the umbilical cord or fetus. The fetal blood is tested for signs
of
anemia and other blood problems. FBS is also known as
cordocentesis or percutaneous umbilical cord blood sampling.
FBS is usually used when a
Doppler ultrasound and/or a series of
amniocentesis tests have first shown moderate to
severe anemia.
If you are
Rh-sensitized and you are carrying an Rh-positive
fetus, your
immune system can attack the fetus's red blood cells.
FBS is used to look at a fetus's red blood cell count and oxygen level, and it
also looks for signs that your immune system is destroying fetal red blood
cells.
What happens
FBS is performed in a hospital's outpatient surgery department. You
will probably be given a
sedative to reduce your and the fetus's movement
during the FBS procedure.
- The fetus may be given an injection of medicine
that temporarily stops movement.
- A small area of your abdomen is
numbed with an injection of
local anesthetic.
- Ultrasound is used to
guide a needle through your abdomen into an umbilical vein in the
umbilical cord.
- A small amount of blood is
withdrawn into the needle and collected.
You may be given more medicine during FBS, such as
antibiotics to prevent infection or medicine to prevent preterm labor
(tocolytic drugs).
Why It Is Done
If Doppler ultrasound and/or amniocentesis tests show moderate to
severe anemia, FBS is then used. FBS is usually reserved for use after these
tests because of its greater risks-up to 2% of pregnancies miscarry after FBS,
and up to 50% lead to worsened Rh sensitization problems. (This happens after
fetal blood mixes with the mother's blood during the blood sampling.)footnote 1
Results
FBS is usually used when a Doppler ultrasound and/or a series of
amniocentesis tests have first shown moderate to severe anemia. Fetal blood
tests show the oxygen level, red blood cell condition, and red blood cell
count. This helps your doctor plan the best treatment for you during your
pregnancy.
If the effects of Rh sensitization are severe and the fetus has
severe anemia, a fetal
blood transfusion may be done immediately. Future
transfusions may be scheduled to keep the fetus healthy until it can be
delivered safely.
What To Think About
FBS can be done as early as the 17th week of pregnancy, in the
middle of the second
trimester.
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References
Citations
- Moise KJ (2009). Hemolytic disease of the fetus and newborn. In RK Creasy, R Resnik, eds., Creasy and Resnik's Maternal-Fetal Medicine, 6th ed., pp. 477-503. Philadelphia: Saunders Elsevier.
Credits
ByHealthwise Staff
Primary Medical ReviewerSarah Marshall, MD - Family Medicine
Adam Husney, MD - Family Medicine
Specialist Medical ReviewerKirtly Jones, MD - Obstetrics and Gynecology
Current as ofMarch 16, 2017
Current as of:
March 16, 2017
Moise KJ (2009). Hemolytic disease of the fetus and newborn. In RK Creasy, R Resnik, eds., Creasy and Resnik's Maternal-Fetal Medicine, 6th ed., pp. 477-503. Philadelphia: Saunders Elsevier.