Invasive procedures for fetal diagnosis in the Perinatal Centre of Central Bohemia have been used since 1977. The rate of perinatal mortality in the Czech Republic decreased in this time from 15 per 1000 to 6.5 per 1000 in 1995. The reasons for this success are the advances in obstetrics and neonatology and also the improvement in prenatal diagnosis. Three main methods of prenatal diagnosis: amniocentesis (AMC), chorionic villi sampling (CVS) and cordocentesis (FBS) have been used for the detection of chromosomal aberrations and inherited disorders. All methods of invasive prenatal diagnosis have been performed with continuous ultrasound guidance and transabdominally. Prenatal diagnosis is indicated since the 11th week of gestation as a prevention of transversal limb reduction anomalies of infants. Chromosomal abnormalities in a group of 3098 patients have been detected in 1.4% of the fetuses. The inherited disorders were diagnosed using DNA analysis and biochemical investigation of the amniotic fluid. There were 30.8% of X-linked disorders prenatally detected in a group of 68 indicated pregnancies and 17.2% of inborn error of metabolism in a group of 29 patients indicated for prenatal diagnosis. The incidence of fetal losses for all methods of prenatal diagnosis before the 28th week of gestation was below 1%. The prenatal diagnosis has been used not only for genetic reasons but also for other indications, e.g. the management of IUGR, gas analysis and the detection of intrauterine fetal distress, fetal Rh/D/ typing in cases of Rh isoimmunisation, amniotic fluid investigation for fetal lung maturation, detection of infection, etc. The abnormal ultrasound findings of fetal malformation are an absolute indication for the invasive procedure.