[Early intra-amniotic bleeding and its results: dangers of chorionic villi sampling and early amniocentesis].

Abstract

Four human fetuses are described exhibiting malformations related to EIAB. Two of these fetuses were aborted as a result of early prenatal diagnostic procedures: one after transcervical CVS, one after early amniocentesis. In three of these fetuses intraamniotic bleeding originating from the umbilical vein near the umbilical insertion produced cords of clotted blood and blood clots adhering to the surface of the fetus. Subsequently, the clots were organized by invading mesenchymal fibroblasts from fetal skin. The cords bent around extremities produced amputations (TLD) and constricted the umbilical vessels, if bent around the umbilical cord. The organizing surface blood clots located predominantly in the folds of the embryo, or fetus, influenced the growth of underlying tissues, producing oblique facial clefts, microphthalmia or micrognathia. EIAB represents a serious complication of invasive procedures related to prenatal diagnosis and must be regarded as the cause of malformations, such as TLD, or ADAM sequence. To avoid EIAB, CVS and amniocentesis should not be done before the end of the 11th gestational week.