Sampling pure fetal blood in twin pregnancies by fetoscopy using a single uterine puncture

A technique for sampling pure fetal blood in twin pregnancies using a single uterine entry with a fetoscope is described. The fetoscope was inserted into one sac and after blood had been obtained from that, twin, the fetus in the other sac was sampled by trans-septal passage of the blood-sampling needle. This was done in six out of seven patients, the first in the series having two separate insertions of the fetoscope, one into each sac. Pure fetal blood was taken from all 14 fetuses, either from the placental insertion of the umbilical cord or the umbilicus, and the volume of the samples ranged from 200 μl to 1200 μl. In six patients the fetuses were at risk of β-thalassaemia and in one of haemophilia A. Some observations are made relating zygosity to the ultrasonic and fetoscopic appearance of the septum between the sacs.