Abstract
Objective
To assess whether positive flow cytometry quantification of fetal red blood cells
is associated with adverse maternal and neonatal outcomes in cases of mild trauma
during pregnancy.
Study Design
A retrospective database study was conducted at a single tertiary center between 2013
and 2019. All pregnant women with viable gestation involved in trauma who underwent
flow cytometry quantification of fetal red blood cells were included in the study.
Flow cytometry was considered positive (≥0.03/≥30 ml). Composite adverse maternal
and neonatal outcome was defined as one or more of the following: intrauterine fetal
death, placental abruption, pre-term birth <37 weeks of gestation, immediate premature
rupture of the membranes, and immediate delivery following trauma. Univariate analysis
was performed followed by multivariate logistic regression analysis controlling for
potential confounders, to assess the role of flow cytometry in predicting adverse
maternal and neonatal outcome. Adjusted odds ratios (aORs) and 95% confidence intervals
(CIs) were calculated.
Results
During the study period 1023 women met inclusion and exclusion criteria. The mechanisms
of injury were motor vehicle accident in 387 women (38%), falls in 367 (36%), direct
abdominal injury in 353 (35%) and in 14 women (1%) other mechanism of injury. Flow
cytometry was considered positive (≥0.03/≥30 ml) in 119 women (11.6%) with median
result of 0.03 [0.03–0.04], and negative in 904 women (88.4%) ((≤0.03/≤30 ml) with
median result of 0.01 [0.01–0.02].
Composite adverse outcome occurred in 8% of the women involved in trauma during pregnancy,
with no difference between the groups with vs. without positive flow cytometry (4.2%
vs. 8.5%; p = 0.1). Positive flow cytometry was not associated with any adverse maternal
or neonatal outcome. This was confirmed on multivariate analysis controlling for potential
confounders.
Conclusion
Flow cytometry result is not related to adverse maternal and fetal/neonatal outcome
of women involved in minor trauma during pregnancy. We suggest that flow cytometry
should not be routinely assessed in pregnant women involved in minor trauma.
Keywords
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Article info
Publication history
Published online: September 17, 2021
Accepted:
September 13,
2021
Received in revised form:
August 19,
2021
Received:
May 11,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
