Fetal responses to inadvertent contact with the needle during amniocentesis.

Fetal responses in 7 cases of mid-trimester amniocentesis, complicated by inadvertent contact between the amniocentesis needle and fetal parts, were analyzed by retrospective videotape review. The incidence of inadvertent needle contact with the fetus was 0.4% (7 of 1,458). Responses included brisk withdrawal of the 'involved' small part in all cases, with the exception of a fetus with lumbosacral meningomyelocele, which failed to withdraw the foot upon direct contact with the needle. Neurologic examination was normal in all neonates except for one with meningomyelocele whose defect was at the L3-L5 level. This patient exhibited paralysis of intrinsic foot muscles and hip extensors. Surgical closure of the defect was performed 12 h after birth. At 2 years of age, no significant improvement in this patient's neurologic condition was noted. Further research is needed to assess the validity of the response to needle contact as a predictor of neonatal neurologic compromise.