The frequency of diagnostic amniocentesis is increasing. Fetal bleeding and trauma have long been recognized to be complications of amniocentesis. For detection of fetomaternal bleeding, efficacy of modified Kleihauer-Betke staining and α-fetoprotein elevation in maternal blood was assessed. Preamniocentesis ultrasound scanning was found useful in reducing the incidence of fetomaternal bleeding and bloody taps. Elevation of a-fetoprotein was found to be a more sensitive indicator of fetomaternal bleeding than was modified Kleihauer-Betke staining. The use of a-fetoprotein to detect fetomaternal bleeding associated with amniocentesis is suggested for the identification of Rh-negative patients requiring anti-D 7-globulin to prevent sensitization.
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