Trauma and pregnancy: is flow cytometry detection and quantification of
fetal red blood cells useful? A retrospective cohort study
Abstract
Objective: To assess whether positive flow cytometry quantification of
fetal red blood cells is associated with adverse outcomes in cases of
mild trauma during pregnancy. Design: A retrospective computerized
database cohort. Population: Pregnant women with viable gestation
involved in trauma who underwent flow cytometry. Flow cytometry was
considered positive (≥0.03/≥30 ml). Methods: A univariate analysis was
followed by a multivariate analysis. Main outcome measures: 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. Results: During the
study 1023 women met inclusion and exclusion criteria. Among the cohort,
119 women (11.6%) had positive flow cytometry (≥0.03/≥30 ml) with
median result of 0.03 [0.03-0.04], while 904 women (88.4%) had
negative flow cytometry test result (≤0.03/≤30 ml) with median result of
0.01 [0.01-0.02]. Composite adverse outcome occurred in 8% of the
women, with no difference in 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 a multivariate analysis. Conclusions: 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.