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DESCRIPTION
Amniocentesis is the removal of fluid from the amniotic sac during pregnancy to test for various genetic and health related issues in the fetus. For more information about this procedure, see Amniocentesis, How To Perform The Procedure.
REASONS FOR PROCEDURE
Laboratory examination of amniotic fluid helps diagnose abnormalities of the unborn child. The best time for genetic amniocentesis is between the 14th and 20th weeks of pregnancy. There is ample fluid for the testing, and time to treat certain problems before the baby is born, and enough time exists if the parents decide not to continue with the pregnancy. Amniocentesis is often done for one or more of the following reasons:
- Maternal age is over 35 years.
- Patient had abnormal results from blood screening test such as maternal serum alpha-fetoprotein (MSAFP or AFP) test.
- Metabolic disease risk (because of previous experience or family history).
- Neural tube defect risk (because of previous experience or family history).
- Either parent has a chromosome abnormality.
- Mother carries a sex-linked abnormality;, and the sex of the unborn child must be determined.
- Unborn child's maturity or other conditions must be determined late in pregnancy.
- To evaluate pregnancy for infection.
- To evaluate fetal lung maturity.
RISK INCREASES WITH
Obesity.
Previous abdominal surgery.
Previous infection in pelvic organs.
This procedure is a very invasive procedure and should only be performed by a skilled, qualified health care practitioner or technician to reduce the risks of fetal or maternal injury, fetal death and miscarriage. If a mother has a Rh negative blood factor, she may need to discuss the need of a Rhogam injection after the procedure is performed to reduce the risk of Rh-Isoimmunization.
DESCRIPTION OF PROCEDURE
A local anesthetic may be injected into the abdomen.
A hollow needle is inserted through the abdominal wall into the uterus. The needle will cause temporary pain, but should not hurt more than any injection.
Amniocentesis is usually performed using continuous ultrasound to allow constant view of the needle's path.
A small amount of amniotic fluid is suctioned through the needle, and the needle removed. Your body will make more fluid to replace the amount that is removed.
Amniocentesis, How To Perform The Procedure.
EXPECTED OUTCOME
Results of the laboratory test of the amniotic fluid take about 10-14 days. More than 95 percent of amniocentesis tests indicate no abnormalities. Some couples who may have high risk factors want the procedure done to reduce their anxiety during pregnancy. However, normal amniocentesis results cannot guarantee a child without defects. At present there are no tests for all abnormalities.
POSSIBLE COMPLICATIONS
Miscarriage triggered by procedure (test).
Damage to the baby, such as dimpling of the skin where the baby was poked during the procedure and a possibility that a baby may die.
Excessive bleeding.
If the mother is Rh Negative blood type and fetus is Rh Positive blood type, a possibility of maternal Rh antibody sensitization may occur.
Surgical wound infection.
TREATMENT
GENERAL MEASURES
Bathe and shower as usual. You may wash the injection site gently with mild unscented soap.
You may experience some mild lower abdominal cramping.
MEDICATION
Medicine is usually not necessary.
ACTIVITY
Rest for 2 or 3 hours following the procedure. There are usually no further restrictions on your normal activities unless the health care provider or your midwife advises you differently.
DIET
No special diet. However, continue to follow your prenatal dietary plan as recommended by your midwife or health care provider.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
Any of the following occurs:
- Any significant loss of fluid from the vagina (clear watery fluid may indicate a break of the amniotic sac with amniotic fluid being lost).
- Nausea and vomiting.
- Significant cramping or pain in the lower abdomen or shoulder.
- Bleeding from the vagina or puncture site.
- Signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
Warning!!! As with all invasive procedures, this procedure should be done only when it absolutely necessary and when the benefits of the test outweigh the serious risks involved with performing the procedure. Amniocentesis SHOULD NOT be a normal, routine part of general obstetric care and is NOT needed by the general healthy population of pregnant women. It should be approached with caution and common sense by both the health care provider and the pregnant woman.
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