Development and initial experience with a manually controlled spring wire device ("Cordostat") to aid in difficult funipuncture.

Abstract

Funipuncture has evolved as a useful tool in prenatal diagnosis and treatment. The ease with which it can be performed depends on placental implantation site, amniotic fluid volume, fetal presentation and activity, gestational age, and operator experience. Under select circumstances, such as hydramnios, oligohydramnios/anhydramnios, a back-up fetus/posterior placenta, or gestation of fewer than 20 weeks, funipuncture can be difficult or impossible. We have developed a new instrument, the "Cordostat," which can help the operator perform difficult funipuncture by providing stabilization and allowing intrauterine manipulation of the umbilical cord. The instrument consists of a deflecting wire guide threaded through a 19.5-guage trochar needle, which can be manually controlled to coil around and stabilize a free loop of cord. Conventional funipuncture can then be performed through a second uterine puncture. We describe use of this instrument in 12 patients undergoing second-trimester induced abortion.