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Abstract
Fetomaternal blood leakage in a volume sufficient to cause alloimmunization is most common at delivery, occurring in 15% to 50% of births. The amount of fetal blood entering the maternal circulation is usually less than 0.1 ml but may be greater than 30 ml. A volume less than 0.5 ml of whole fetal blood is detected in 93 % of women. FMH of 30 ml or more occurs in just 3 out of 1000 women. (22)
There are various risk factors for the development of FMT and they have a profound effect on the newborn’s and mother’s general health. Therefore, proper laboratory diagnosis of FMT is mandatory for its management. (24)
Our study was initiated to provide insight into the relationship between drainage of the placenta and the level of fetal RBC transfer into the maternal circulation during C.S.
The present study included one hundred women attending the Shatby Maternal University hospital. The subjects were divided into two groups, with each group being further subdivided into two subgroups;
Group I: 50 pregnant women undergoing placental drainage.
Subgroup A: 25 pregnant women undergoing cord traction.
Subgroup B: 20 pregnant women undergoing manual placental removal.
Group II: 50 pregnant women not undergoing placental drainage.
Subgroup C: 25 pregnant women undergoing cord traction.
Subgroup D: 25 pregnant women undergoing manual placental removal.
Flow cytometry has been determined to be the best indicator of fetal hemoglobin in the maternal circulation. (29)
The laboratory results obtained were statistically analyzed using SPSS/PC (statistical package for social science for personal computers) and the results were discussed.
The following results were obtained:
- There was no significant difference regarding maternal age, gestation, birth weight, blood group and Rh typing.
- There was no significant difference as regards the type of anesthesia used and the indication for C.S.
- There was a significant increase (p=0.001*) in the number of patients with FMT among patients without placental drainage compared to patients with placental drainage.
- There was no significant difference when cord traction was compared to manual removal in patients with and without placental drainage regarding FMT.
- There was a significant increase (p=0.041*) in the number of patients with FMT in patients with cord traction but without placental drainage compared to patients with cord traction and placental drainage.
- There was a significant increase (p=0.0037*) in the number of patients with FMT in patients with manual placental removal without placental drainage compared to patients with manual placental removal with placental drainage.
- There was a significant difference (p=0.001*) in the quantity of fetal RBCs in patients with placental drainage compared to patients without placental drainage.