Korean J Obstet Gynecol.  2004 Nov;47(11):2091-2097.

The Association of Fetal Heart Rate Pattern following Cordocentesis with Pregnancy outcome

Affiliations
  • 1Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Korea.
  • 2Department of Obstetrics and Gynecology, College of Medicine, Sungkyunkwan University, Samsung Cheil Medical Center, Seoul, Korea.
  • 3Department of Obstetrics and Gynecology, Kangseo Mizmedi Hospital, Seoul, Korea.

Abstract


OBJECTIVE
The cordocentesis is regarded as an useful procedure for the prenatal evaluation of fetal disease, but it's complications are fetal loss, umbilical cord bleeding, umbilical cord hematoma, fetal bradycardia, fetomaternal hemorrhage, abruptio placentae, and chorioamnionitis due to it's invasiveness. The fetal bradycardia following cordocentesis is transient and self-limited in most cases, and the prevalence rate of fetal bradycardia following cordocentesis was reported to be between 1.5 and 13 per cent. The purpose of this study was to evaluate the association of fetal heart rate pattern following cordocentesis with adverse pregnancy outcome.
METHODS
We investigated retrospectively the fetal heart rate following cordocentesis, the Apgar score of neonate, the birth weight of neonate, gestational age at delivery, preterm delivery, intrauterine growth retardation, stillbirth, and chromosome analysis in 64 codocenteses between 1 February 2000 and 28 February 2001. Normal fetal heart rate was defined as 100 up to 170 bpm, fetal bradycardia as less than 100 bpm lasting one more minute, and fetal tachycardia as more than 170 bpm lasting one more minute.
RESULTS
1. Fetal heart rate pattern following the cordocentesis was normal in 53 cases (82.8%), bradycardia in 6 cases (9.4%) and tachycardia in 5 cases (7.8%). 2. The pregnancy outcome was well-being fetus at birth in 51 cases, terminated pregnancy in 5 cases, intrauterine growth restricted fetus in 5 cases, preterm birth in 1 case and intrauterine death in 2 cases. 3. Mean Apgar-1minute/-5minute scores in neonates were 8.4 +/- 0.2/9.3 +/- 0.2 in the normal fetal heart rate group, 6.8 +/- 1.7/7.6 +/- 1.9 in fetal bradycardia group and 8.4 +/- 0.2/9.4 +/- 0.2 in fetal tachycardia group, that showed no statistically significant difference between groups. 4. The gestational weeks at birth/birth weight were 38.9 +/- 0.4 weeks/3193 +/- 90 g in normal fetal heart rate group, 36.8 +/- 3.2 weeks/2733 +/- 340 g in bradycardia group and 40.0 +/- 0.2/3465 +/- 21 g in tachycardia group, that showed no statistically significant difference between groups. 5. The number of puncture at the same time of cordocentesis was one in 45 cases, two in 15 cases and three in 4 cases. 6. There was no difference in fetal heart rate pattern following cordocentesis between 60 cases of normal and 4 cases of abnormal cardiovascular findings sonographycally. 7. The karyotyping was normal in 60 cases and abnormal in 4 cases, each of which was 46,XY,inv(9),46,X,i(Xq)/45,X,47,XY,+mar, and 46,XX,t(7;15)(q10;q10) respectively.
CONCLUSION
Fetal bradycardia or tachycardia following cordocentesis was not associated with adverse pregnancy outcomes.

Keyword

Cordocentesis; Fetal heart rate; Pregnancy outcome; Fetal anomaly

MeSH Terms

Abruptio Placentae
Apgar Score
Birth Weight
Bradycardia
Chorioamnionitis
Cordocentesis*
Female
Fetal Diseases
Fetal Growth Retardation
Fetal Heart*
Fetomaternal Transfusion
Fetus
Gestational Age
Heart Rate, Fetal*
Hematoma
Hemorrhage
Humans
Infant, Newborn
Karyotyping
Parturition
Pregnancy
Pregnancy Outcome*
Pregnancy*
Premature Birth
Prevalence
Punctures
Retrospective Studies
Stillbirth
Tachycardia
Umbilical Cord
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