Efficacy and safety of cordocentesis for prenatal diagnosis

Objective: To assess the efficacy and safety of diagnostic cordocentesis. Methods: Between January 1991 and May 2004, 2010 cordocenteses were performed in the outpatient setting in 2010 women with singleton pregnancies. A fixed needle guide and a 22-gauge percutaneous needle were used and no more than 2 attempts were allowed at 1 visit. In most cases, the umbilical vein was the target vessel. The results of each procedure and pregnancy outcomes were recorded and analyzed. Results: The most frequent indication for cordocentesis was risk of severe thalassemia (59.0%), followed by a need for rapid karyotyping (30.0%). Most of the procedures (97%) were performed in the free cord loop and the remaining at the cord insertion. The overall success rate was 98.4%, with 80.0% of the successful procedures performed at the first needle insertion and the remaining 20% at the second insertion. Transient bleeding was observed at the puncture site in 19.8% of cases and transient fetal bradycardia in 4.9% of cases. The total fetal loss and cordocentesis-related loss rates within 2 weeks of cordocentesis were 2.7% and 1.0%, respectively, before 24 weeks of gestation and 1.9% and 0.8% after 24 weeks. The other obstetric complications were unremarkable. Conclusions: Cordocentesis is a simple, safe, and reliable procedure for prenatal diagnosis.