Early amniocentesis at 11–14 weeks' gestation for the diagnosis of fetal chromosomal abnormality—a clinical evaluation

Hackett, Gerald; Smith, J. H. F.; Rebello, George; Gray, C. T. H.; Rooney, D. E.; Beard, R. W.; Loeffler, F. E.; Coleman, D. V.

doi:10.1002/pd.1970110506

Cited by 43 publications

(19 citation statements)

References 6 publications

(4 reference statements)

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“…These results compare favorably with pre viously published observational studies of EA where the estimated rates of procedure-relat ed fetal loss range from 3.3 to 6.6% [7][8][9][10][11][12], In a series of 1,800 EA procedures (at 10 weeks and 4 days to 13 weeks and 6 days) recently reported by Eibcn ct al. [13], the total fetal loss rate (to 24 weeks) was 1%, which is also not significantly different from the current study [1.8% to 24 weeks (95% Cl 0.3-3.4%)].…”

Section: Discussionsupporting

confidence: 75%

“…In addition, recent findings concerning the asso ciation of CVS with limb reduction abnormal ities have placed the relative safety of CVS in question [4][5][6], Early amniocentesis (EA), performed be tween 11 and 14 weeks of gestation, is an alternative to both CVS and MA that appears to combine the safety of MA with earlier availability of results. While preliminary data suggest that the safety and accuracy of EA is similar to MA, none of the studies to date have had the power to adequately assess the risk of fetal loss, particularly between 11 and 12 weeks of gestation [7][8][9][10][11][12]. Nonetheless, EA is gradually gaining clinical acceptance in many centers in both North America and Europe.…”

Section: Introductionmentioning

confidence: 99%

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The Early Amniocentesis Study: A Randomized Clinical Trial of Early Amniocentesis versus Midtrimester Amniocentesis

et al. 1996

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Objectives: The primary purpose of this pilot study was to determine whether the safety of early amniocentesis (EA; 11 weeks to 12 weeks and 6 days) is similar to midtrimester amniocentesis (MA; 15 weeks to 16 weeks and 6 days). The secondary objectives were to determine the cytogenetic success and accuracy of EA compared with MA. Methods: This prospective, randomized clinical trial compared continuous ultrasound-guided EA and MA (22-gauge needle) in patients at a late maternal age (≥ 35 years). The procedures were compared for safety, success and accuracy. Results: Among the 683 women randomized and followed to pregnancy completion, there was a total of 27/344 (7.8%) and 25/339 (7.4%) fetal losses (spontaneous and induced abortions) in the EA and MA groups, respectively (difference 0.4%; CI ––3.6 to 4.4%). The rate of postprocedure spontaneous fetal loss was 2.4% (8/330) in the EA group and 3.3% (10/299) in the MA group (NS). The procedure success rate at the first attempt was 97.6% in the EA group and 99.7% in the MA group. There were no diagnostic errors, and all but 2 EA cultures were successful (both repeated successfully). The perinatal outcome was similar in both groups. Conclusions: EA appears to be as safe and accurate as MA. A large multicentered, randomized trial is currently underway to verify these results.

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Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

The Early Amniocentesis Study: A Randomized Clinical Trial of Early Amniocentesis versus Midtrimester Amniocentesis

et al. 1996

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“…Other congenital malformations such as talipes and congenital dislocated hips have been reported at an increased incidence following amniocentesis. Hackett et al [10] identified four congenital abnormalities (imperfo rate anus, hemangioma of the tongue, two positional tal ipes) in 62 babies following EA at 11-14 weeks.…”

Section: Discussionmentioning

confidence: 99%

The Early Amniocentesis Study: A Randomized Clinical Trial of Early Amniocentesis and Midtrimester Amniocentesis

Wilson

Johnson²,

Windrim³

et al. 1997

Fetal Diagn Ther

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The present study provides detailed neonatal and congenital malformation follow-up from 695 women enrolled in a prospective randomized multicenter study comparing the safety and accuracy of early (11–12 weeks of gestation) and midtrimester amniocentesis (15–16 weeks of gestation). No differences were found for total pregnancy loss (difference 0.4%; CI ––3.6 to 4.4%), obstetrical or neonatal outcome. The incidence of congenital anomalies was 2.4 and 2.6% for the early amniocentesis and midtrimester amniocentesis groups, respectively. Respiratory problems were present in 2.1 and 1.6%, respectively. Musculoskeletal problems were present in 0.9 and 2.4%, respectively. It must be emphasized that before early amniocentesis can be considered as an alternative to midtrimester amniocentesis or chorionic villus sampling, careful evaluation of any fetal effects must be considered and further large randomized trials are necessary.

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“…2 Early ultrasound (12-14 weeks) is also a reliable option when performed at specialized centers. [3][4][5] Invasive testing, either using chorionic villus sampling from 11 weeks or amniocentesis from 15 weeks, [6][7][8] is also an option and allows definitive genetic diagnosis, but both techniques carry a small but significant miscarriage risk (B1%). 9 When used for determination, NIPD has a number of advantages over ultrasound and invasive testing.…”

Section: Introductionmentioning

confidence: 99%

Non-invasive prenatal diagnosis for fetal sex determination: benefits and disadvantages from the service users’ perspective

et al. 2012

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Prenatal fetal sex determination is clinically indicated for women who are at risk of having a child with a serious genetic disorder affecting a particular sex. Ultrasound has been the traditional method used, but early fetal sex determination using non-invasive prenatal diagnosis (NIPD) can now be performed using cell-free fetal DNA in maternal plasma. The study aim was to assess the views and experiences of service users who had used NIPD for fetal sex determination. In this paper, we report on the perceived benefits and disadvantages. A qualitative approach using semi-structured interviews was used. A total of 44 participants (38 women and 6 partners of participating women) were recruited. Participants' views and experiences of NIPD were overwhelmingly positive. Concerning benefits over traditional methods, three themes emerged: (1) technical aspects of technology; (2) timing; and (3) enhanced decision-making. Practical advantages of NIPD included avoiding miscarriage, and there were a number of psychological advantages associated with timing such as perceived control, early re-engagement, normalization of pregnancy and peace of mind. Participants also valued NIPD as it enabled a stepwise approach to decisionmaking. A number of disadvantages were discussed including concerns about social sexing and increased bonding at a time in pregnancy when miscarriage risk is high. However, participants felt these were fairly minor in comparison with the advantages of NIPD. Until definitive genetic diagnosis using NIPD is available, NIPD for fetal sex determination is perceived as a good interim measure with a number of notable advantages over traditional methods.

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Early amniocentesis at 11–14 weeks' gestation for the diagnosis of fetal chromosomal abnormality—a clinical evaluation

Cited by 43 publications

References 6 publications

The Early Amniocentesis Study: A Randomized Clinical Trial of Early Amniocentesis versus Midtrimester Amniocentesis

The Early Amniocentesis Study: A Randomized Clinical Trial of Early Amniocentesis versus Midtrimester Amniocentesis

The Early Amniocentesis Study: A Randomized Clinical Trial of Early Amniocentesis and Midtrimester Amniocentesis

Non-invasive prenatal diagnosis for fetal sex determination: benefits and disadvantages from the service users’ perspective

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