Five cases of brain injury following amniocentesis in mid‐term pregnancy

Abstract

This paper describes the neuroimaging and neuropathological findings in five cases of severe brain damage after traumatic mid‐trimester amniocentesis, all performed between 1986 and 1994. Although fetal injury after amniocentesis has been reported, reports of brain injury are infrequent. Continuous ultrasound monitoring may reduce the risk of fetal injury but follow‐up ultrasound scans can be falsely reassuring. Withdrawal of blood‐stained fluid, particularly if it contains tissue fragments, should alert the operator to the possibility of fetal damage. Histological examination of such tissue fragments may confirm the nature of the fetal damage. The consequences of fetal brain injury are severe, all five of our cases showed evidence of disruption of brain development compatible with mid‐term injury. Obstetricians and their patients should be aware of the small but significant risk of brain damage after mid‐term amniocentesis.

ISUOG Practice Guidelines: invasive procedures for prenatal diagnosis

“…The occurrence of needle injury to the fetus is extremely rare. Sporadic injuries have been reported in older case reports, particularly those using unguided procedures, and included ocular trauma, cutaneous injuries (dimpling and scarring), tendon trauma, trauma in the fetal vessels and brain injury (including porencephaly) ( EVIDENCE LEVEL: 3 ).…”

Renewed focus on the developing human neocortex

“…Alcohol, radiation, diet and infection could all have an impact on cortical development. Some very rare cases of brain injuries are associated with diagnostic procedures (Squier et al 2000). Pasko Rakic has even suggested that ultrasound examination may impede the migration of developing neurons in embryonic mouse cortex (Ang et al 2006) and work on this subject in nonhuman primates is underway.…”

The Neuropathology of Autism

“…Several studies have reported the presence of nonspecific antenatal disruptive lesions in autism. These have provided for interrelated pathologies, for example schizencephaly, polymicrogyria, heterotopias (7, 45, 65, 75, 94, 106, 117). Schizencephaly is presently regarded as a destructive lesion occurring before 28 weeks as areas of polymicrogyric cortex are often found in the walls of the cleft and elsewhere in the brain.…”