Couples with alpha-thalassaemia-1 face a 25 per cent risk of having fetuses with haemoglobin (Hb) Bart's disease. Prenatal diagnosis is conventionally performed by DNA studies of chorionic villi or amniocytes obtained from chorionic villus biopsy or amniocentesis. DNA studies are expensive and time-
Cordocentesis at 16–24 weeks of gestation: experience of 1320 cases
✍ Scribed by Theera Tongsong; Chanane Wanapirak; Chairat Kunavikatikul; Supatra Sirirchotiyakul; Wirawit Piyamongkol; Pharuhas Chanprapaph
- Publisher
- John Wiley and Sons
- Year
- 2000
- Tongue
- English
- Weight
- 61 KB
- Volume
- 20
- Category
- Article
- ISSN
- 0197-3851
No coin nor oath required. For personal study only.
✦ Synopsis
The objective of this study was to assess the safety and ef®cacy of diagnostic cordocentesis at midpregnancy. 1320 singleton pregnancies with no obvious congenital anomalies, a gestational age of 16±24 weeks, and proper indications underwent cordocentesis using the freehand technique. The results of each procedure was prospectively collected and subsequently analysed for the results and pregnancy outcomes. The mean maternal age was 31.1 years and 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 ®rst attempt. The mean duration of the procedure was 10.5 min and was signi®cantly longer in the ®rst 50 cases of practice for each operator. The maternal blood contamination rate was higher when the cord insertion was targeted. The procedure-related complications included transient bleeding at puncture site (20.2%), transient fetal bradycardia (4.3%), chorioamnionitis (two cases), and cord haematoma (one case). Of 1281 successful cases, 184 fetuses had severe disease. The total fetal loss rate was 3.2% and the procedure-related loss was 1%. The other obstetric complications were comparable with those in the general population. We conclude that cordocentesis at midpregnancy is a useful, relatively safe, and effective procedure for prenatal diagnosis.
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