Indications and Interventions in Prenatal Diagnosticsin Eight Centers in the Czech Republic

Overview

Objective:
To register the spectrum of indications and types of invasive procedures in clinicalpractice.Methods: We offered participation in the project to all prenatal diagnostic centres in the CzechRepublic. 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 fromeight 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, umbilicalvessel coagulation) participate with less than 2%. Only 0.5% cases recorded amniocentesiscomplications. Of the 277 well-documented cordocentesises, we noted only one seriouscomplication, or 0.36%. The steadily increasing number of amniocenteses contributes to theincreased number of invasive prenatal procedures. In only 64.5% of our database, based onverifi able higher risk, amniocentesis was indicated.Discussion: The spectrum of invasive procedures in Czech Republic appears quite broad but ifwe separate amniocentesies, we observe that other procedures are performed sporadically andonly some centres. Out eight participating centres perform six types of procedures less than 20times 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 screeningwill likely lead to an increase in chorionic villus sampling. Indications, quantity, resultsand complications of all invasive procedures should be registered and audited.

Key words:
amniocentesis, cordocentesis, prenatal invasive methods