The value of cordocentesis in management of patients with severe preeclampsia.

Severe preeclampsia affects placental function and causes fetal compromise. It is necessary to deliver the fetus at an appropriate time in order to minimize fetal mortality and morbidity. Cordocentesis was performed in 9 patients with severe preeclampsia (group 1) and 10 patients with other pregnancy complications (group 2). Intrauterine growth retardation occurred in 5 patients in group 1 and in only one patient in group 2. Blood gas parameters including pH, pO2 and O2 saturation were significantly lower for group 1, while pCO2 was significantly higher, as compared to group 2. For patients in group 1, non-invasive fetal surveillance successfully identified 5 patients with fetal compromise, who required immediate termination of pregnancy. All 5 of these patients had abnormal fetal blood gas analyses by cordocentesis. Fetal blood gas analysis was abnormal in 2 additional fetuses among the remaining 4 patients who exhibited normal findings by non-invasive methods of fetal surveillance. These results suggest that cordocentesis is useful in identifying fetal compromise (fetal hypoxia/acidosis) prior to the onset of labor in high-risk patients, such as preeclampsia associated with intrauterine growth retardation.