A single physician's experience with four thousand six hundred genetic amniocenteses

Objectives: Counseling on prenatal diagnosis requires accurate knowledge of the associated risks, including fetal loss. The objective of our study was to assess this risk of amniocentesis in a single center with several operators. Methods: This retrospective analysis concerns only women with singleton pregnancies who underwent amniocentesis between 14⁺⁰ and 23⁺⁶ weeks’ gestation. Results: During this 4.5-year period, 5,780 amniocenteses were performed, of which we analyzed 5,319. The rate of fetal loss was 70 in 4,858 tests (1.4%), with a lost-to-follow-up rate of 3.8%. Conclusion: Our results for fetal loss are comparable to those in the largest series with fewer operators already published.

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“…The rate of fetal loss was 1.44%. Our results for fetal loss are comparable to those in the larger series already published [3][4][5][6][7] .…”

Section: Discussionsupporting

confidence: 89%

Fetal Loss after Amniocentesis in a Series of 5,780 Procedures

Gaudry

Grangé²,

Lebbar³

et al. 2008

Fetal Diagn Ther

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“…Mean sizes of the regions of interests were for the lung 615 mm 2 Lung volume ranged from 12.3 to 143.5 cm 3 , liver volume from 17.0 to 211.0 cm 3 and fetal body volume from 354 to 3,750 cm 3 , all increasing with gestational age (P<0.001). Relative lung/total body volume ranged from 1.6 to 5.0%, liver/total body volume from 4.3 to 7.7% and lung/liver volume from 29.7 to 100.0%.…”

Section: Resultsmentioning

confidence: 96%

“…Diagnosis of lung maturity currently relies on surfactant-related lipid levels in amniotic fluid withdrawn by amniocentesis [1,2]. Non-invasive imaging is clearly preferable.…”

Section: Introductionmentioning

confidence: 99%

MR assessment of fetal lung development using lung volumes and signal intensities

et al. 2004

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The purpose of this study was to evaluate the monitoring and diagnostic potential of MRI in fetal lung development and disease using lung volume and signal intensity changes through gestation. Thirtyfive healthy fetuses (22-42 weeks) were examined on a 1.5-T MR system using sagittal T2w singleshot fast spin-echo imaging (TR indefinite, TE 90 ms, slice thickness/gap 3-5/0 mm, FOV 26-40 cm, NEX 0.5). Fetal body and lung were segmented manually and volumes calculated. Signal intensities (SI) of fetal lung and three reference values were measured on the section best displaying the lung. Regions of interests were defined by including the maximal organ area possible. The following SI ratios were generated: lung/liver, lung/amniotic fluid, lung/muscle, liver/fluid and liver/ muscle. Volumes and ratios were correlated with gestational age. Data from seven fetuses with pulmonary pathology were compared with these normative values. Absolute lung volume varied from 12.3 to 143.5 cm 3 in correlation with gestational age (P<0.001); lung volume relative to total body volume ranged from 1.6 to 5.0%, decreasing with gestational age (P=0.001). All SI ratios measured were unrelated to gestational age. Diagnoses in the seven abnormal fetuses were hydrothorax (n=2), congenital cystic adenomatoid malformation (n=2), diaphragmatic hernia (n=2) and pulmonary sequestration (n=1); their absolute and relative lung volumes were below normal (P<0.001). The SI ratios did not differ significantly from those in the normal population. Normative MR fetal lung volumes may have important clinical applications in confirming and quantifying intrauterine pulmonary hypoplasia and in complementing ultrasound in the planning of fetal and post-natal surgery. No clinical relevance was found for fetal lung SI values.

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“…However, detailed information about the procedure and the outcomes must be given to the patient before application. In previous studies, older maternal age is seen to be an indication for amniocentesis [13]. An age of 35 years and above has been accepted as older maternal age.…”

Section: Discussionmentioning

confidence: 97%

“…However, in later studies the rates of fetal loss associated with amniocentesis were reported as 0.06%-0.8% [11]. The reduction in the rates of fetal loss associated with amniocentesis over the years can be considered to be due to the more widespread use of ultrasound with high resolution probes and the increasing experience of those implementing the procedure [12,13]. In the current study, fetal loss within 4 weeks of amniocentesis was seen in 2 (0.5%) patients, which was consistent with literature.…”

Section: Discussionmentioning

confidence: 99%

Does Amniocentesis Increase the Rates of Fetal Loss and Poor Pregnancy Outcomes?

Ercan¹,

Köstü²,

Arslan³

et al. 2016

Ann Clin Anal Med

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ÖzetAmaç: Kliniğimizde son 5 yılda amniosentez yapılan hastalarda işleme bağ-lı fetal kayıp riskinin ve kötü gebelik sonuçlarının artıp artmadığını değer-lendirmek. Gereç ve Yöntem: Bu retrospektif çalışma Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum kliniğinde 2011 Ocak ile 2015 Temmuz tarihleri arasında amniosentez yapılan 387 hastanın dosyalarından ve genetik merkezin kayıtlarından incelenerek yapıldı. Ayrıca kliniğimize kontrole gelen ve amniosentez yapılmayan düşük riskli 250 hasta kontrol grubu olarak belirlendi. Bulgular: Çalışma süresince amniosentez endikasyonu olan 688 hasta mevcuttu. Bunlardan 387 hastaya amniosentez yapıldı. %43.8 amniosentez reddetme oranı mevcuttu. En sık amniosentez endikasyonu anormal Down sendromu tarama testi iken (%57.6), 2. sık-lıkla ileri maternal yaş (%22.5) görülmektedir. Amniosentez yapılan hastaların 24'ünde (%6.2) kromozomal anormallik mevcut olup bunlar içerisinde en sık Down sendromu izlendi (%54). Amniosentez sonrası fetal kayıp 2 hastada (%0.5) görülmüştür. Toplamda kötü gebelik sonuçlarına bakıldığında amniosentez yapılanlarda 8, kontrol grubunda 5 hastada kötü gebelik sonuçları izlenmiş olup gruplar arasında istatisitksel anlamlı fark yoktu (p=0.263). Tartışma: Amniosentez günümüzde sıklıkla kullanılan invaziv prenatal tanı testidir. İşleme bağlı olarak gebelik komplikasyonlarında bir artış görülmemekte-dir. Amniosentez öncesinde hastalara mutlaka yapılacak işlem ve sonuçları hakkında detaylı danışmanlık verilmelidir. Anahtar KelimelerAmniosentez; İleri Maternal Yaş; Down Sendromu Riski Abstract Aim: To evaluate the risk of fetal loss and poor pregnancy outcomes associated with amniocentesis procedures on patients in our clinic in the last 5 years. Material and Method: This retrospective study was conducted by examining the hospital records and genetic centre records of 387 patients who underwent amniocentesis at the Gynaecology and Obstetrics

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A single physician's experience with four thousand six hundred genetic amniocenteses

Cited by 37 publications

References 13 publications

Fetal Loss after Amniocentesis in a Series of 5,780 Procedures

Fetal Loss after Amniocentesis in a Series of 5,780 Procedures

MR assessment of fetal lung development using lung volumes and signal intensities

Does Amniocentesis Increase the Rates of Fetal Loss and Poor Pregnancy Outcomes?

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