Amniocentesis First introduced by Serr and Fuchs and
Amniocentesis First introduced by Serr and Fuchs and Riis in the 1950 s for fetal sex determination p Only at the late 70 th a static ultrasound was used to locate the placenta and amniotic fluid pocket p Only In 1983, Jeanty reported a technique of amniocentesis ’’under ultrasound vision’’ p
INDICATION genetic p Lung maturity p Infection p Hemolytic anemia p NTD p Coagulopathy p Polyhydramnious treatment p
Post procedural care Rhogam Discolored sample contamination
complications Pregnancy loss 0. 3 -1. 0%. p Increase risk: p n n n Needle larger than 18 g Multiple needle insertion Discoloration of the fluid High AFP, multiple late abortions, previous vaginal bleeding Placental perforation – recent studies didn’t find correlation
Complications Leakage of amniotic fluid p Amnionitis: HCV, CMV, TOXO , HIV p Vaginal bleeding p Fetal injury p Long term complications: p n n Respiratory distress? Isoimmunization?
Amniocentesis and HIV positive women Increased rate of vertical transmission p Chemoprophylaxis previous to amniocentesis appears to be beneficial in preventing vertical transmission p
Multiple Gestation p Three methods: n n Indigo carmine injection to the first sac A single needle puncture sampling technique (Jeanty 1990) n Simultaneous visualization of two needles on each side of the separating membrane (Bahado. Singh 1992) n n Abortion risk – probably higher Detailed description of fetus position and placental location
Thank you
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