Cordocentesis at 16-24 weeks of gestation: experience of 1320 cases

The objective of this study was to assess the safety and efficacy of diagno stic cordocentesis at midpregnancy. 1320 singleton pregnancies with no obvi ous congenital anomalies, a gestational age of 16 24 weeks, and proper indi cations underwent cordocentesis using the freehand technique. The results o f each procedure was prospectively collected and subsequently analysed for the results and pregnancy outcomes. The mean maternal age was 31.1 years an d the mean gestational age at the time of cordocentesis was 19.8 weeks. The most common indication was the risk of severe thalassaemia syndrome (69.8% ) and was followed by rapid karyotyping. Of 1320 cordocenteses. 1281 (97%) were done successfully at the first attempt. The mean duration of the proce dure was 10.5 min and was significantly longer in the first 50 cases of pra ctice for each operator. The maternal blood contamination rate was higher w hen the cord insertion was targeted. The procedure-related complications in cluded transient bleeding at puncture site (20.2%), transient fetal bradyca rdia (4.3%). chorioamnionitis (two cases), and cord haematoma (one case). O f 1281 successful cases, 184 fetuses had severe disease. The total fetal lo ss rate was 3.2% and the procedure-related loss was 1%. The other obstetric complications were comparable with those in the general population. We con clude that cordocentesis at midpregnancy is a useful, relatively safe, and effective procedure for prenatal diagnosis. Copyright (C) 2000 John Wiley & Sons, Ltd.