The effect on pregnancy outcome of transplacental needle insertion was studied in 401 consecutive women attending for early amniocentesis between 10 and 14 completed weeks of pregnancy. Transplacental early amniocentesis was associated with a significantly higher incidence (P < 0.001) of blood-stained amniotic fluid taps but a lower incidence (not significant; P > 0.05) of pregnancy loss and miscarriages. Women in the nontransplacental early amniocentesis group had a significantly higher (P < 0.01) incidence of late procedure-related antenatal complications, such as preterm rupture of membranes or preterm labour. Our study showed that transplacental early amniocentesis is a safe procedure; contrary to present recommendations, the study also showed that avoiding the placenta during early amniocentesis is an unnecessary practice.