Summary:
Objective: To register the spectrum of indications and types of invasive procedures in clinical
practice.
Methods: We offered participation in the project to all prenatal diagnostic centres in the Czech
Republic. We provided a database for entering the necessary data in Microsoft Access format.
During the period of 2002-2003, we obtained data of 5800 prenatal diagnostic procedures from
eight centres.
Results: The data analysis revealed that the amniocentesis was the most used procedure
– 90.2%- Cordocentesis 4.8%, termination of pregnancy 2.34%, and multifetal reduction 1.03%.
All other procedures (intraumbilical transfusion, amniodrainage, amnioinfusion, early amniocentesis
< 15th week of pregnancy puncture of fetal organs, chorionic villus sampling, umbilical
vessel coagulation) participate with less than 2%. Only 0.5% cases recorded amniocentesis
complications. Of the 277 well-documented cordocentesises, we noted only one serious
complication, or 0.36%. The steadily increasing number of amniocenteses contributes to the
increased number of invasive prenatal procedures. In only 64.5% of our database, based on
verifi able higher risk, amniocentesis was indicated.
Discussion: The spectrum of invasive procedures in Czech Republic appears quite broad but if
we separate amniocentesies, we observe that other procedures are performed sporadically and
only some centres. Out eight participating centres perform six types of procedures less than 20
times a year.
Conclusions: Invasive prenatal diagnostics in Czech Republic is represented mainly by amniocentesis.
Cordocentesis is performed routinely but in few centres. Advances in 1st trimester screening
will likely lead to an increase in chorionic villus sampling. Indications, quantity, results
and complications of all invasive procedures should be registered and audited.
Key words:
amniocentesis, cordocentesis, prenatal invasive methods
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