Fetal Ductus Venosus Flow Velocity Waveforms and Maternal Serum Afp Transabdominal Chorionic Villus Sampling before and after First-trimester

Doppler flow velocity waveform recording in the fetal ductus venosus and umbilical artery as well as maternal blood sampling for serum alpha-fetoprotein (MSAFP) was performed before and after transabdominal chorion Mtlus sampling (TACVS) in 36 women of advanced maternal age (3 36 years). Gestational age ranged between 11 and 13 weeks. No chromosomal anomaly was detected. No statistically sigrulicant difference was observed in ductus venosus velocity parameters or in the umbilical artery pulsatility index (PI) before and after C V S in 35 women with a normal pregnancy outcome. One case resulted in fetal loss. Post-CVS median MSAFP levels at 12 weeks (25 kIUA) and 13 weeks (35 k W A ) were significantly higher than pre-CVS levels. In three cases, post-CVS MSAFP levels were higher than 600 kIUA, correlating with feto-maternal transfusions of approximately 1.0-1.4 ml, i.e., of around 40 per cent of feto-placental blood volume. One of these cases displayed absence of fetal peripheral blood flow velocities and fetal bradycardia following TACVS, resulting in fetal loss 1 week later. The remaining two cases had a normal pregnancy outcome, but showed a more than 50 per cent reduction in ductus venosus velocity after TACVS, whereas umbilical artery PI remained unchanged. However, similar velocity changes were associated with only small feto-maternal transfusions. Umbilical artery PI values remained unchanged.