-
British Medical Bulletin Oct 1983
Review
Topics: Abortion, Induced; Adult; Amniocentesis; Female; Humans; Pregnancy; Pregnancy Trimester, Second; United Kingdom
PubMed: 6357341
DOI: 10.1093/oxfordjournals.bmb.a071842 -
Journal of Gynecology Obstetrics and... Apr 2023Our study evaluated the contribution of amniocentesis in the diagnostic approach of small-for-gestational-age fetuses (SGA) without morphological abnormality identified...
OBJECTIVE
Our study evaluated the contribution of amniocentesis in the diagnostic approach of small-for-gestational-age fetuses (SGA) without morphological abnormality identified on ultrasound by studying FISH (fluorescence in situ hybridization) for chromosomes 13, 18 and 21, CMV PCR (cytomegalovirus polymerase chain reaction), karyotype and CGH (genomic hybridization array) METHODS: Our single-center retrospective cohort study included pregnant women referred for prenatal diagnosis for a SGA fetus in whom amniocentesis was performed between 2016 and 2019. A SGA fetus was defined as a fetus with an estimated fetal weight (EFW) below the 10th percentile according to referral growth curves in use. We evaluated the number of amniocenteses with an abnormal result and identified factors that may be associated with this outcome.
RESULTS
Among the 79 amniocenteses performed, there were 5 (6.3%) abnormalities: karyotype (1.3%) and CGH (5.1%). No complications were described. We did not find any statistically significant factors associated with abnormal amniocentesis findings even if some elements seemed reassuring such as late discovery (p = 0.31), moderate SGA (p = 0.18), normal head, abdomen and femur measurements (p = 0.57), but without statistically significant difference.
CONCLUSION
Our study found 6.3% pathological analysis of amniocenteses, of which several would have been missed by conventional karyotyping. Patients must be informed about the risk of detecting abnormalities of low severity, with low penetrance or with unknown fetal consequences that could be source of anxiety.
Topics: Pregnancy; Female; Humans; Infant, Newborn; Amniocentesis; Gestational Age; Retrospective Studies; In Situ Hybridization, Fluorescence; Fetal Growth Retardation; Fetus; Infant, Newborn, Diseases
PubMed: 36796639
DOI: 10.1016/j.jogoh.2023.102552 -
Ultrasound in Obstetrics & Gynecology :... Dec 2014
Topics: Amniocentesis; Female; Humans; Pregnancy; Ultrasonography, Prenatal
PubMed: 25449117
DOI: 10.1002/uog.14680 -
The Medical Journal of Australia Mar 1976A retrospective survey of 358 consecutive amniocenteses was undertaken. The incidence of failure was 37 (9.6%); most commonly this was due to oligohydramnios. A...
A retrospective survey of 358 consecutive amniocenteses was undertaken. The incidence of failure was 37 (9.6%); most commonly this was due to oligohydramnios. A suprapubic tap was the most likely to be successful, but was accompanied by premature rupture of membranes in 3.8% of the cases. Spontaneous rupture of membranes, followed by delivery of a premature infant, occurred 15 times (4.2%). Blood-stained fluid was obtained on 47 occasions (13%), but, apart from the theoretical risks of fetomaternal haemorrhage and fetal exsanguination, and an association with maternal abdominal pain, there appeared to be no serious sequelae from this complication. Withdrawal of blood-stained fluid was not prevented by prior placental localization and was not related to the site of the tap. There were 14 perinatal deaths (equal to a rate of 50 per 1,000 births) and, although no fetal deaths could be directly attributed to amniocentesis, there were four cases in which the procedure could not be completely absolved. Three patients underwent emergency caesarean section because of severe abdominal pain after anmiocentesis. Two had amniotic fluid peritonism and the third had minor intraperitoneal bleeding. Amniocentesis is not without maternal and fetal complications and should be undertaken with due regard to the risks involved.
Topics: Amniocentesis; Amniotic Fluid; Blood; Female; Fetal Death; Fetal Membranes, Premature Rupture; Fetomaternal Transfusion; Humans; Labor Onset; Obstetric Labor, Premature; Pregnancy; Pregnancy Complications; Retrospective Studies
PubMed: 1272119
DOI: No ID Found -
Journal of Perinatal Medicine Mar 2023Chorioamniotic separation (CAS) at the time of standard amniocentesis (AC) is a risk factor for postprocedural complications and should be avoided. The aim of this study...
OBJECTIVES
Chorioamniotic separation (CAS) at the time of standard amniocentesis (AC) is a risk factor for postprocedural complications and should be avoided. The aim of this study was to quantify procedure-related risks after AC with a 29G-needle in cases of CAS, and evaluation of perinatal outcome in CAS after 15 weeks' gestation (GW).
METHODS
Retrospective analysis of genetic AC with a pencil-point 29G needle after 15 completed GW in pregnancies, in which the fetal membranes were not yet fused. Included into the study were women aged 16-44 years with at least 15 completed GWs referred for second trimester AC to identify fetal chromosomal aberrations.
RESULTS
437 ACs were made in total with the 29G-needle. The median maternal age was 30 (16-44) years. 145 cases showed CAS where the distance between chorion and amnion was 0.10-10.02 mm at AC. 38 pregnancies were terminated, 37 of which had a genetic disorder. The risk of aneuploidy increases by a factor of 2 (95% CI 1.4-2.8) for every 1 mm of CAS enlargement. No procedure-related complications were found up to two weeks after the AC.
CONCLUSIONS
CAS seems to be massively underreported. Early diagnosis in case of CAS is something to strive for as CAS could be an indicator of genetic abnormalities - a "soft marker". With the atraumatic 29G needle, the risk of complications after AC in CAS seems to be very low.
Topics: Pregnancy; Humans; Female; Male; Amniocentesis; Retrospective Studies; Amnion; Pregnancy Trimester, Second; Maternal Age
PubMed: 36068008
DOI: 10.1515/jpm-2022-0229 -
Geburtshilfe Und Frauenheilkunde Jun 1990Preliminary clinical experience with early amniocentesis is reported. Fifty-two amniocenteses were performed before the end of the 14th week following the last menstrual...
Preliminary clinical experience with early amniocentesis is reported. Fifty-two amniocenteses were performed before the end of the 14th week following the last menstrual period. Cytogenetic and biochemical analyses (AFP, AChE) were performed. Increasing experience with amniotic fluid samples containing small-cell populations and the use of combined culture media improved the poor initial results to a 100% level, thus enabling the use of this technique for diagnostic purposes. The sampling technique and the post-procedural evolution of twelve amniocenteses in pregnant women, whose pregnancy is to be continued, are presented. The possibility of performing amniocentesis in early pregnancy is discussed with reference to anatomical aspects (amniotic and chorionic cavity).
Topics: Acetylcholinesterase; Adult; Amniocentesis; Amniotic Fluid; Chorionic Villi Sampling; Female; Humans; Karyotyping; Maternal Age; Pregnancy; Pregnancy Trimester, First; Pregnancy, High-Risk; Thalassemia; alpha-Fetoproteins
PubMed: 1695882
DOI: 10.1055/s-2008-1026279 -
Archives of Gynecology and Obstetrics Aug 2009To describe the experiences in diagnostic amniocentesis in twin pregnancies.
OBJECTIVE
To describe the experiences in diagnostic amniocentesis in twin pregnancies.
METHODS
The computerized database and medical records of pregnant women attending Maternal Fetal Medicine Unit of the hospital for diagnostic amniocentesis at 16-20 weeks gestation between January 1992 and December 2006 were retrospectively reviewed.
RESULTS
During 15 years of experience, 7,890 amniocenteses at 16-20 weeks gestation were performed for prenatal diagnosis, including 174 procedures in 87 twin pregnancies. The mean gestational age at the time of amniocentesis was 17.13 +/- 3.35 weeks. Preterm birth rate defined as the delivery before 36 gestational weeks was 36.24%. The total fetal loss rate was 5.17%, however, the procedure related fetal loss within 2 weeks after the procedure was 1.15%.
CONCLUSION
Based on our limited data and previous studies, we can counsel patients undergoing twin amniocentesis at mid-trimester that the fetal loss rate may be slightly higher than that of singleton amniocentesis.
Topics: Abortion, Spontaneous; Adult; Amniocentesis; Female; Fetal Mortality; Humans; Pregnancy; Retrospective Studies; Twins
PubMed: 19112573
DOI: 10.1007/s00404-008-0894-y -
Ultrasound in Obstetrics & Gynecology :... May 2019Traditionally, amniocentesis is performed between 17 and 23 weeks of gestation. This enables decisions regarding the course of pregnancy to be made before viability....
OBJECTIVE
Traditionally, amniocentesis is performed between 17 and 23 weeks of gestation. This enables decisions regarding the course of pregnancy to be made before viability. Less frequently, amniocentesis is performed in the third trimester. Advanced genomic technologies such as chromosomal microarray analysis (CMA) provide more detailed information about the fetus compared with traditional G-banded chromosomal analysis. The aim of this study was to assess the indications for and safety of late amniocentesis, genetic-test results (especially in the context of CMA technology) and outcome of pregnancies that underwent the procedure after 24 weeks.
METHODS
Medical records were analyzed retrospectively of all women in whom amniocentesis was performed at a gestational age of 24 + 0 to 38 + 6 weeks, at Hadassah Medical Center, between June 2013 and March 2017. Parameters investigated included indications for late amniocentesis, complications, CMA results and pregnancy outcome.
RESULTS
During the study period, 291 women (303 fetuses, 277 singleton and 14 twin pregnancies; in two twin pairs, one fetus was terminated before amniocentesis) underwent late amniocentesis. CMA was performed in all instances of amniocentesis. The most frequent indication was abnormal sonographic finding(s) (204/303 fetuses, 67%). Preterm delivery occurred in 1.7% and 5.1% of pregnancies within the first week and within 1 month following the procedure, respectively. Aneuploidy was detected in nine (3%) fetuses and nine (3%) others had a pathogenic/likely pathogenic copy number variant, suggesting that CMA doubled the diagnostic yield of traditional karyotyping. Maximal diagnostic yield (17.5%) was achieved for the subgroup of fetuses referred with abnormal sonographic findings in two or more fetal anatomical systems. Variants of uncertain significance or susceptibility loci were found in another nine (3%) fetuses.
CONCLUSIONS
In pregnancies undergoing late amniocentesis, CMA increased detection rates of fetal abnormalities and had a shorter turnaround time compared with traditional chromosomal analysis; therefore, late amniocentesis may serve as a helpful tool for detecting fetal abnormalities or reassuring parents following late-appearing abnormal sonographic findings. However, CMA may expose findings of uncertain significance, about which the couple should be precounseled. The procedure appears to be safe. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
Topics: Adult; Amniocentesis; Congenital Abnormalities; Female; Gestational Age; Humans; Microarray Analysis; Pregnancy; Pregnancy Trimester, Third; Reproducibility of Results; Retrospective Studies; Time Factors
PubMed: 30155922
DOI: 10.1002/uog.20113 -
British Medical Journal Dec 1979
Topics: Amniocentesis; Female; Genetic Counseling; Humans; Pregnancy; Pregnancy, Multiple; Twins
PubMed: 526808
DOI: 10.1136/bmj.2.6203.1455 -
Prenatal Diagnosis Nov 2007Amniocentesis in the third trimester, which reduces risks of procedure-related miscarriage but still allows termination of affected fetuses, may be applicable in some...
BACKGROUND
Amniocentesis in the third trimester, which reduces risks of procedure-related miscarriage but still allows termination of affected fetuses, may be applicable in some pregnancies. The implications of deferring amniocentesis include complications, delivery before the test and increased amniotic fluid culture failure rates. We investigated the indications, complications, karyotype results and laboratory failure rates of third-trimester amniocentesis.
METHODS
We studied all women who underwent third-trimester amniocentesis from 2000 to 2006. Data were collected from ultrasound databases, computerised records and individual chart review.
RESULTS
We reviewed 165 pregnancies that underwent amniocenteses after 28 weeks. Median maternal age at amniocentesis was 32 years and median gestation, 32(+2) weeks. Indications included malformation (60/165), soft markers (37/165), maternal request (12/165), and positive screening test (11/165). Of the 49 women(29.7%) who declined second-trimester amniocentesis, 24.5% had twins and 38.8%, malformations. Amniocentesis was not offered to 116 women: 57/116 (49.1%) third-trimester referrals, 25/116 (21.5%) diagnosed late and the remainder, low-risk indications. Fetal karyotype was abnormal in 17 cases (10.3%). Seven women who initially declined amniocentesis had abnormal results compared with one advised to have late amniocentesis. Culture failure rate was 9.7%, however results were obtained by Quantitative fluorescent polymerase chain reaction (QF-PCR) from 164/165 samples. Complication rate was 1.2%.
CONCLUSION
For late diagnoses and for low-risk indications, third-trimester amniocentesis is an acceptable option, especially when utilising QF-PCR with cytogenetic culture.
Topics: Adult; Algorithms; Amniocentesis; Female; Humans; Middle Aged; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, Third
PubMed: 17636852
DOI: 10.1002/pd.1820