[Indications and interventions in prenatal diagnostics in eight centers in the Czech Republic]

To register the spectrum of indications and types of invasive procedures in clinical practice.

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.

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 verifiable higher risk, amniocentesis was indicated.

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.

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.