Ultrasonography-guided cordocentesis in the first 100 singleton pregnancies

Objectives: To access the factor that might influence the Success rate, safety and reliability of Cordocentesis.

Design: Analysis of the outcome of the first 100 cases of Cordocentesis.

Setting: The Outpatient Prenatal Diagnosis and Therapy Laboratory of a University Tertiary Care Centre.

Methods and materials: A review of the first Cordocentesis procedures performed at the Prenatal Diagnosis & Therapy Centre by the Author is presented. Medical records were reviewed for the maternal age, indication, gestational age, frequency of needle insertion, complications of Cordocentesis delivery, results of prenatal testing and pregnancy outcomes. Complete follow up data were available n = 98 (98%) and in two cases, reports were not complete.

Results: There were n = 2 miscarriages in gestation before 28 weeks and after 28 weeks, 3 still births (due to viral infection). The most frequent indication was the risk of haemoglobinopathy (sickle cell disease) (28%), followed by the need to rule out Parvovirus infection (22%), Cytomegalovirus (18%), Toxoplasmosis (13%), Rubella (13%) and Rh (-) 6%. Most of the procedure (93%) were performed in the free cord loop and the remaining at the cord insertion. The overall success rate was 98% with 75% of the successful procedures performed at the first needle insertion and the remaining 15% at the second insertion. Transient bleeding was observed at the puncture site in 21% of the cases and transient fetal bradycardia in 4% of the cases. The total Cordocentesis related loss rate within 2 weeks of procedure was 2%.

Conclusion: Cordocentesis is relatively safe and is a reliable method of prenatal Diagnosis. It must be done like other procedures by experienced personnel.