Journal Mobile Options
Table of Contents
Vol. 23, No. 3, 2008
Issue release date: February 2008
Fetal Diagn Ther 2008;23:237–244

Fetal Cardiocentesis: A Review of Indications, Risks, Applications and Technique

Sarno, Jr. A.P. · Wilson R.D.
aMaternal-Fetal Medicine Section, Perinatal Center, St. Luke’s Hospital and Health Network, Bethlehem, Pa., and bCenter for Fetal Diagnosis and Treatment, Children’s Hospital of Philadelphia, Philadelphia, Pa., USA

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Objectives: To review the indications, applications and technique of fetal cardiocentesis. Methods: Review of published case reports and case series of fetal cardiocentesis utilizing the PubMed search engine of the National Library of Medicine. Results: Case reports and case series demonstrate that fetal cardiocentesis may be an alternative method by which to facilitate prenatal diagnosis, intravascular therapy, multifetal and selective fetal reduction and in utero therapy of congenital heart disease. However, procedure-associated risk is higher than with cordocentesis and may limit use of this procedure. Conclusions: Fetal cardiocentesis may be a reasonable option to obtain fetal intravascular access and facilitate therapeutic interventions when cordocentesis fails or is not feasible. However, expected benefit must clearly outweigh the procedure-associated risk.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Goncalves LF, Lee W, Espinoza J, Romero R: Three- and four-dimensional ultrasound in obstetric practice. Does it help? J Ultrasound Med 2005;24:1599–1624.

    External Resources

  2. Hubbard AM: Ultrafast fetal MRI and prenatal diagnosis. Semin Pediatr Surg 2003;12:143–153.
  3. Rodeck CH, Campbell S: Umbilical-cord insertion as a source of pure fetal blood for prenatal diagnosis. Lancet 1979;i:1244–1245.

    External Resources

  4. Daffos F, Capella-Pavlovsky M, Foreseier R: A new procedure for fetal blood sampling in utero: preliminary results of fifty-three cases. Am J Obstet Gynecol 1983;146:985–987.
  5. Bang J, Bock JE, Trolle D: Ultrasound-guided fetal intravenous transfusion for severe rhesus haemolytic disease. Br Med J Clin Res Ed 1982;284:373–374.
  6. Ghidini A, Sepulveda W, Lockwood CJ, Romero R: Complications of fetal blood sampling Am J Obstet Gynecol 1993;168:1339–1334.
  7. Liao C, Wei J, Li Q, Li L, Li J, Li D: Efficacy and safety of cordocentesis for prenatal diagnosis. Int J Gynaecol Obstet 2006;93:13–17.
  8. Nicolini U, Nicolaidis P, Fisk NM, Tannirandorn Y, Rodeck CH: Fetal blood sampling from the intrahepatic vein: analysis of safety and clinical experience with 214 procedures. Obstet Gynecol 1990;76:47–53.
  9. Chinnaiya A, Venkat A, Dawn C, Chee WY, Choo KB, Gole LA, Meng CT: Intrahepatic vein fetal blood sampling: current role in prenatal diagnosis. J Obstet Gynaecol Res 1998;24:239–246.
  10. Somerset DA, Moore A, Whittle MJ, Martin W, Kilby MD: An audit of outcome in intravascular transfusions using the intrahepatic portion of the fetal umbilical vein compared to cordocentesis. Fetal Diag Ther 2006;21:272–276.
  11. Sturgiss SN, Wright C, Davison JM, Robson SC: Fetal hepatic necrosis following blood sampling from the intrahepatic vein. Prenat Diagn 1996;16:866–869.
  12. Antsaklis AI, Papantoniou NE, Mesogitis SA, Koutra PT, Vintzileos AM, Aravantinos DI: Cardiocentesis: an alternative method of fetal blood sampling for the prenatal diagnosis of hemoglobinopathies. Obstet Gynecol 1992;79:630–633.
  13. Westgren M, Selbing A, Stangenberg M: Fetal intracardiac transfusions in patients with severe rhesus isoimmunization. BMJ 1988;296:885–886.
  14. Bakos O, Ewald U, Lindgren PG: Fetal cardiocentesis in care of severe Kell immunization. Fetal Diagn Ther 1998;13:372–374.
  15. Rodeck CH, Roberts LJ: Successful treatment of fetal cardiac arrest by left ventricular exchange transfusion. Fetal Diagn Ther 1994;9:213–217.
  16. Ash KM, Mibashan RS, Nicolaides KH: Diagnosis and treatment of feto-maternal hemorrhage in a fetus with homozygous von Willebrand’s disease. Fetal Ther 1988;3:189– 191.
  17. Crowley P, Chalmers I, Keirse MJNC: The effects of corticosteroid administration before preterm delivery. An overview of the evidence from controlled trials. Br J Obstet Gynaecol 1990;97:11–25.
  18. Chervanak FA, McCullough LB: Ethical issues in recommending and offering fetal therapy. West J Med 1993;159:369–399.

    External Resources

  19. Mouw RJ, Klumper F, Hermans J: Effect of atracurium or pancuronioum on the anemic fetus during and directly after intravascular intrauterine transfusion: a double-blind randomized study. Acta Obstet Gynecol Scand 1999;78:763–767.
  20. Weiner CP: Cordocentesis for diagnostic indications: two years’ experience. Obstet Gynecol 1987;70:664–668.
  21. Sarno AP, Feinstein SJ, Bell JG, Parikh R, Papazian K: Emergent fetal intracardiac transfusion for thrombocytopenia and acute hypovolemia due to cordocentesis-associated hemorrhage in parvovirus-induced hydrops. Fetal Diagn Ther 2007;22:124–127.
  22. Westgren M, Selbing A, Stangenberg M, Phillips R: Acid-base status in fetal heart blood in erythroblastotic fetuses: a study with special reference to the effect of transfusions with adult blood. Am J Obstet Gynecol 1989;160:1134–1138.
  23. Enders M, Weidner A, Zoellner I, Searle K, Enders G: Fetal morbidity and mortality after acute human parvovirus B19 infection in pregnancy: prospective evaluation of 1,018 cases. Prenat Diagn 2004;24:513–518.
  24. Rodis JF, Borgida AF, Wilson M, Egan JF, Leo MV, Odibo AO, Campbell WA: Management of parvovirus infection in pregnancy and outcome of hydrops: a survey of members of the Society of Perinatal Obstetricians. Am J Obstet Gynecol 1998;179:985–988.
  25. Von Kaisenberg CS, Jonat W: Fetal parvovirus B19 infection. Ultrasound Obstet Gynecol 2001;18:280–288.
  26. Martin JA, Hamilton BE, Ventura SJ, et al: Births: Final Data for 2001. Hyattville/MD, National Center for Health Statistics, 2002.
  27. Evans MI, Ciorica D, Britt DW, Fletcher JC: Update on selective reduction. Prenatal Diag 2005;25:807–813.
  28. Stone J, Eddleman K, Lynch L, et al: A single center experience with 1,000 consecutive cases of multifetal pregnancy reduction. Am J Obstet Gynecol 2002;17:209–217.
  29. Rochon M, Eddleman KA, Stone J: Invasive procedures in multifetal pregnancies. Clin Perinatol 2005;32:355–371.
  30. Eddleman KD, Stone JL, Lynch L: Selective termination of anomalous fetuses in multifetal pregnancies: two hundred cases at a single center. Am J Obstet Gynecol 2002;187:1168–1172.
  31. Evans MI, Goldberg JD, Horenstein J, et al: Selective termination for structural, chromosomal, and mendelian anomalies: international experience. Am J Obstet Gynecol 1999;181:893–897.
  32. Rustico MA, Baietti MG, Coviello D, Orlandi E, Nicolini U: Managing twins discordant for fetal anomaly. Prenatal Diag 2005;25:766–771.
  33. Bhide A, Sairam S, Hollis B, Thilaganathan B: Comparison of feticide carried out by cordocentesis versus cardiac puncture. Ultrasound Obstet Gynecol 2002;20:230–232.
  34. Gardiner HM, Kumar S: Fetal cardiac interventions. Clin Obstet Gynecol 2005;48:956–963.
  35. Marshall AC, van der Velde ME, Tworetzky W, et al: Creation of an atrial septal defect in utero for fetuses with hypoplastic left heart syndrome and intact or highly restrictive atrial septum. Circulation 2004;110:253–258.
  36. Tworetzky W, Wilkins-Haug L, Jennings RW, van der Velde ME, Marshall AC, Marx GR, Colan SD, Benson CB, Lock JE, Perry SB: Balloon dilation of severe aortic stenosis in the fetus: potential for prevention of hypoplastic left heart syndrome: candidate selection, technique, and result of successful intervention. Circulation 2004;110:2125–2131.
  37. Huhta J, Quintero RA, Suh E, et al: Advances in fetal cardiac intervention. Curr Opin Pediatr 2004;16:487–493.
  38. Quintero RA, Huhta J, Suh E, Chmait R, Romero R, Angel J: In utero cardiac fetal surgery: laser atrial septotomy in the treatment of hypoplastic left heart syndrome with intact atrial septum. Am J Obstet Gynecol 2005;193:1424–1428.
  39. Jouannic JM, Boudjemline Y, Benifla JL, Bonnet D: Transhepatic ultrasound-guided cardiac catheterization in the fetal lamb. A new approach for cardiac interventions in fetuses. Circulation 2005;111:736–741.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50