FETAL BRADYCARDIA FOLLOWING CORDOCENTESIS

Several clinical investigations on the course and outcome of pregnanci es following cordocentesis have mentioned the occurrence of fetal brad ycardia at the time of umbilical cord puncture. The prognostic impact of this common complication has remained controversial. Our purpose wa s to investigate the prevalence and the short-term and long-term conse quences of fetal bradycardia associated with cordocentesis. This study included all 339 cordocenteses performed in 290 fetuses at the Divisi on of Prenatal Diagnosis and Therapy, University of Vienna, between 19 91 and 1994. Clinically significant bradycardia was defined as a drop in the heart rate to less than 100 beats/min for a period of greater t han or equal to 60 s. Bradycardia during or immediately after cordocen tesis was observed in 13 cases (3.8 per cent). The fetal/neonatal loss rate per procedure was 61.5 per cent (8/13) in cases with bradycardia and 3.1 per cent (10/326) in those without bradycardia (P < 0.001). E arly gestational age and hydrops fetalis correlated significantly with the development of bradycardia at cordocentesis. The other risk group s, including fetuses with intrauterine growth retardation, the punctur e site, and the number of puncture attempts did not correlate with fet al bradycardia. Our results indicate that prolonged fetal bradycardia during or after cordocentesis is characteristic of a group of fetuses with an especially unfavourable prognosis. (C) 1997 by John Wiley & So ns, Ltd.