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The amount of fetal-maternal transfusion during invasive intrauterine diagnostic instrumentation was determined by measuring the increase in maternal serum alpha-fetoprotein (delta AFP) caused by the procedure. Fetal liver biopsy or fetoscopy for purposes other than blood sampling caused a mean delta AFP of 11.4 ng/ml and 34.2 ng/ml, respectively. Fetoscopy with fetal blood sampling produced a mean delta AFP of 211.8 ng/ml, while fetoscopy followed by placentesis caused a mean delta AFP of 462.8 ng/ml (representing a 1.07 ml fetal-maternal transfusion). Although this magnitude of fetal-maternal transfusion is an acceptable risk for the fetus, it is a sufficient transfusion to cause blood cell antigen sensitization.
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Simpson et al. (1984) studied this question.
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