Amniocentesis is a procedure in which a doctor takes a sample of amniotic fluid from the uterus for testing.

Amniotic fluid is a special environment that surrounds the fetus and protects it during pregnancy..

This fluid contains fetal cells and various chemicals that it produces during the course of life..

Amniocentesis can be carried out for various reasons:.

• During genetic amniocentesis, a fluid sample is taken to check the fetal DNA for various genetic and chromosomal abnormalities, such as Down syndrome.

• When t. amniocentesis of ripening, amniotic fluid is taken to confirm fetal lung maturation and readiness for birth.

• Amniocentesis is sometimes used to detect fetal infections or other diseases not related to genetics..

• In rare cases, amniocentesis is performed to reduce the volume of amniotic fluid.

Despite the very valuable information that amniocentesis can give about the condition of the fetus, the decision on this invasive procedure must be taken very seriously.. It is very important to be aware of the risks of amniocentesis and be prepared for them.

Why is amniocentesis performed

Amniocentesis is carried out for various reasons..

Genetic Amniocentesis.

Genetic amniocentesis can provide information about fetal DNA. As a rule, genetic amniocentesis is carried out in cases where routine screening allows you to suspect genetic pathologies in the fetus. In this case, amniocentesis is prescribed at an early stage of pregnancy, so that a woman can make a decision to terminate the pregnancy or prepare for the birth of a child with special needs.

Genetic amniocentesis can be performed from the 11th week of pregnancy. Indications for genetic amniocentesis may include:.

• Positive or uncertain result of prenatal screening. If the results of the first trimester screening make it possible to suspect genetic abnormalities, then amniocentesis will be able to accurately confirm or refute the diagnosis.

• Chromosomal abnormalities during previous pregnancies. If the previous pregnancy was accompanied by a neural tube defect or Down syndrome, then the risk in the future increases.

• Mother's age over 35. After 35 years of age, a woman's egg quality gradually deteriorates, which means an increased likelihood of having children with chromosomal abnormalities, including Down Syndrome.

• Family history of specific genetic diseases, carriage of certain genetic pathologies. This applies to dozens of genetic diseases, such as cystic fibrosis (cystic fibrosis).

Amniocentesis of maturation.

This type of amniocentesis helps determine how ready the baby’s lungs are for birth.. Such a procedure is performed only if necessary to cause premature birth, in order to avoid certain consequences for the mother. This test is usually done after 32 weeks of gestation.. It is believed that up to 32 weeks normal development of the lungs of the child is unlikely.

Other causes of amniocentesis:.

• Identification of various infections in the fetus.

• Artificially reduced amniotic fluid volume.

• Determining the severity of anemia in children with Rh conflict - a rare condition in which the mother’s immune system produces antibodies against fetal red blood cells.

A doctor may warn of a high risk of amniocentesis in the following cases:.

• Problems with the placenta, including partial or complete placenta previa or placental abruption.

• Cervical insufficiency is a condition in which weak cervical tissue provokes premature birth and pregnancy loss..

• Past history of preterm birth (up to 34 weeks).

What are the risks associated with this procedure

Amniocentesis, first of all, is an invasive procedure, which is associated with a number of dangers for the fetus:.

• Miscarriage. With amniocentesis during the second trimester, there is a slight risk of miscarriage - it ranges from 1: 300 to 1: 500. Studies show that this risk is even higher in the early stages..

• Damage to the fetus with a needle. During amniocentesis, the fetus can move its arm or leg in the direction of the needle, resulting in injury. However, serious injuries are very rare..

• Leakage of amniotic fluid. In rare cases, amniotic fluid begins to leak after the procedure. If the leak stops, then most likely the pregnancy will proceed normally. However, there may be a permanent leak of amniotic fluid, which can lead to infections and injury to the fetus..

• Rhesus sensitization. Amniocentesis can rarely cause fetal blood cells to enter the mother’s bloodstream.. If the mother has a negative Rhesus factor, then after amniocentesis, they can inject Rh-immunoglobulin, which will prevent a reaction to the baby’s blood.

• spread of infection. If the mother suffers from some infections, including toxoplasmosis, hepatitis C and HIV, then with amniocentesis there is a chance that this infection will get into the fetal blood.

How to prepare for amniocentesis?

If you undergo amniocentesis before the 20th week of pregnancy, then your bladder should be full before the procedure. Some time before the procedure, you need to drink a large amount of water. But from the 20th week of pregnancy, amniocentesis is done after the bladder is empty.

Your doctor will ask you to fill out a special consent form before the procedure.. By signing this form, you agree to all the risks and acknowledge that you are aware of the possible consequences.. Up to this point you should find out all the obscure issues..

Make sure that a loved one accompanies you during the procedure. You may need physical and mental support.. In addition, if you drive to the hospital with your car, someone will have to take you home..

Procedure.

First, the doctor will do an ultrasound of the uterus to see the exact location of the fetus.. You will need to lie on your back, exposing your stomach. The doctor will apply a special gel for ultrasound, after which he will drive the abdomen with a small device (ultrasound probe), and the image of the uterus will appear on the monitor.

Then the doctor will treat the surface of the abdomen with an antiseptic. Under the control of ultrasound, he will insert a thin and long needle through the abdominal wall, which will have to pass through the wall of the uterus. Using a syringe, a small amount of amniotic fluid is taken, after which the needle is removed. The exact amount of amniotic fluid a doctor will take depends on the purpose of the procedure and the duration of the pregnancy..

During amniocentesis, you will need to lie still, because the needle will be in close proximity to the fetus. Careless movement may result in personal injury.. You will feel an unpleasant injection when the needle pierces the skin. The whole procedure usually takes from 20 to 30 minutes.

What will happen after the procedure?

After amniocentesis, the doctor can measure the fetal heart rate.. You may experience cramping and minor vaginal discharge immediately after the procedure.. Stressful physical work should be avoided within 1-3 days after amniocentesis..

Meanwhile, a sample of amniotic fluid will be delivered to the laboratory for research.. Some analysis results will be available in a couple of days.. The doctor will be able to get other results within 1-4 weeks..

You should definitely contact your doctor if you experience:.

• Continuous discharge of fluid from the vagina.

• Unusual vaginal bleeding.

• Pain and cramping lasting several hours.

• Increase in body temperature.

• Redness and inflammation at the injection site.

• Unusual fetal activity or lack of movement.

Procedure results.

Only your doctor will help you understand the significance of certain results of amniocentesis.. With genetic amniocentesis, the results will help to reliably rule out various genetic and chromosomal abnormalities, such as Down syndrome.. However, amniocentesis cannot identify all congenital malformations..

If amniocentesis has shown a chromosomal or genetic pathology that cannot be cured, you will have the painful question of aborting. It is necessary to consult a doctor about a disease that was discovered in the fetus, and collect as much information as possible before such a responsible decision.

With amniocentesis of maturation, the test will reliably show the readiness of the baby's lungs for birth. The decision to initiate childbirth should be made depending on the circumstances, the existence of a threat to the life of the child and mother.

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