EXPERIENCE OF A SINGLE TEAM OF OPERATORS IN 891 DIAGNOSTIC FUNIPUNCTURES

Objective: To assess the efficacy and safety of diagnostic funipunctur e. Methods: Between October 1985 and November 1993, fetal circulation was accessed 891 times in 828 pregnancies The technique was similar to that described in earlier studies. We did not make more than two atte mpts at the procedure in any session. Each procedure was recorded pros pectively in a computerized data base. Data included information about indications, laboratory indites, gestational age, number of successfu l and failed punctures, duration of fetal bradycardia, duration of ble eding, ultrasonographic findings, follow-up of pregnancies, and perina tal outcome. Results: The most frequent indication was rapid karyotypi ng (48.9%), followed by risk of congenital infection (38.6%). The succ ess rate of the method was high (98.6%). Most samples (97%) were pure fetal blood, undiluted by amniotic fluid. Transient bleeding was obser ved from the cord puncture site in 9.8% of the procedures. Transient f etal bradycardia was noted in 7% of the procedures. Sixty-three percen t of prolonged bradycardia occurred in growth-retarded or congenitally malformed fetuses. Seven fetal and neonatal deaths (five pregnancies) occurred within 1 week after the funipuncture; the funipuncture indic ation was rapid karyotyping in four of these cases. Conclusion: Funipu ncture performed by operators trained in ultrasonic needle guidance is a safe and reliable procedure.