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Monday, April 13, 2009

Amniotic Fluid Examination

10:20 AM
Also known as:-

Amniocentesis

Indications for amniocentesis

1. The mother is 35 or older at the time of delivery. The probability of fetal malformation increases with age. Up to 35, the increase in probability is slow; but after 35, probability of fetal malformation increases rapidly.
2. The mother has delivered a baby with chromosome abnormalities.
3. One of the parents is a balanced translocation carrier or has abnormalities with chromosome structure.

4. A close relative has Down Syndrome or other chromosome abnormality.
5. There is a danger of Mendelian or polymeric genetic diseases such as cleft lip, cystic fibrosis, and Tay-Sachs disease.
6. In the past, children or parents have had a neural-tube defect, or the mother's blood serum (fetoprotein or triple screen) test results were abnormal.
7. The fetus appears abnormal on ultrasound.
8. Mother has given birth to a baby with multiple major malformations, but has not received a cytogenetic examination.
9. There is danger of a severe sex-linked genetic disease, and the sex of the baby needs to be determined.
10. A significant answer has been given to a genetic screening question.
11. The mother is worried about fetal deformation and requests an examination.



Examining the amniotic fluid

Generally, it is ideal to perform or undergo an amniocentesis between the 15th and 18th week of the pregnancy, when the success rate for cultivating fetal cells is high. However, since it takes 3 weeks to cultivate cells, abnormalities may not be discovered until the 5th month of the pregnancy. Recently, early amniocentesis examinations have been performed between the 11th and 14th weeks of gestation. An early amniocentesis carries a 2.5 times higher risk of miscarriage than an amniocentesis conducted during weeks 15 through 18.

How the fluid is examined

After the mother's abdomen is draped and prepped, a 3- to 6-inch needle is used to penetrate the abdomen and uterus to collect amniotic fluid from the amniotic sac. Approximately 20-30 ml is needed for cultivation, and additional fluid may be collected for DNA analysis.

Complications with the examination

The three main dangers associated with amniocentesis are: injury to the mother and fetus, infection, and miscarriage or premature labor.

(For mothers with Rh-negative blood who are bleeding, special precautions and procedures will be necessary to avoid iso-immunization in the mother).

The chance of losing a baby from an amniocentesis performed during weeks 15 to 18 is approximately 1 in 200 to 1 in 300 procedures, similar to the chance of losing a baby during this time if an amniocentesis was not performed. Therefore, an amniocentesis performed during weeks 15 to 18 is considered relatively safe.

Contraindications

Most pregnant women can safely undergo an amniocentesis. Special circumstances that prevent the use of an amniocentesis are: if symptoms of infection are present; if the woman refuses to undergo the procedure; if danger of a premature birth exists.

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