Reproductive outcome following amniocentesis for genetic indications

Porreco, Richard P.; Young, Philip; Resnik, Robert; Cousins, Larry; Jones, Oliver W.; Richards, Terri; Kernahan, Colleen; Matson, Melinda R.

doi:10.1016/0002-9378(82)90110-7

Cited by 38 publications

(5 citation statements)

References 13 publications

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“…In contrast with previously published data (Mennuti et al, 1980;Porreco et al, 1982;Tabor et al, 1986;Kappel et al, 1987), we found that transplacental amniocentesis is associated with significantly fewer complications, in particular transient amniotic fluid leakage in the 30 days following the procedure, whereas the incidence of spontaneous abortion seems to be comparable for the two approaches.…”

Section: Discussioncontrasting

confidence: 99%

“…Previous studies published in the literature report that an anterior placental location is more at risk because a transplacental puncture is associated with a higher incidence of complications (Mennuti et al, 1980;Porreco et al, 1982; Tabor CCC 0197-3851/94/090803-04 et al, 1986;Kappel et al, 1987). However, these studies have some of the following drawbacks: in some cases, they were performed prior to the introduction of real-time ultrasound-guided techniques; they were collaborative studies introducing a number of variables such as different techniques, equipment, and operator experience; and the range of gestational age when amniocentesis was performed was sometimes too great, thus introducing another possible bias in the results obtained.…”

Section: Introductionmentioning

confidence: 96%

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Transplacental amniocentesis: Is it really a higher‐risk procedure?

Giorlandino¹,

Mobili²,

Bilancioni³

et al. 1994

Prenatal Diagnosis

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The aim of this study was to compare transplacental with non-transplacental amniocentesis in terms of related complications. Between January 1991 and December 1992, 4564 genetic amniocenteses were performed in 4527 patients (4491 singleton, 35 twin, and one triplet pregnancy) at 15-16 weeks of gestation. All the procedures were ultrasound-guided and performed by the same operator. In 1487 cases, an anterior placenta was traversed with the needle, whereas in 3077 cases, the needle was inserted directly into the amniotic cavity without traversing the placenta. After the exclusion of patients in whom amniotic cell culture failed or in whom an abnormal karyotype was obtained, and of patients lost to follow-up, a total of 4454 patients (98 per cent) were followed for 30 days after amniocentesis. Two spontaneous abortions occurred after a transplacental procedure, and five after a nontransplacental procedure (P = not significant). There were no episodes of amniotic fluid leakage in the first group, whereas 16 ruptures of the membranes that resolved spontaneously occurred in the second group (P < 0.01). Our data suggest that transplacental amniocentesis carries a similar abortive risk to and a lower risk of transient rupture of the membranes than non-transplacental amniocentesis and may therefore be preferred at the gestational period examined (15-16 weeks). However, the risk of feto-maternal haemorrhage, which is reported to be higher for a transplacental procedure, must be considered in the case of an anterior placenta.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Transplacental amniocentesis: Is it really a higher‐risk procedure?

Giorlandino¹,

Mobili²,

Bilancioni³

et al. 1994

Prenatal Diagnosis

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“…It has been proposed that the localization of the " placenta influences the rate of spontaneous abortion after AC. 9 The analysis of the data presented in this study shows that placental localization per se is not of significance, but that perforation of the placenta increases the risk of SA considerably. These findings are consistent with those of others.…”

Section: Discussionmentioning

confidence: 63%

Incidence of Spontaneous Abortion After Amniocentesis: Influence of Placental Localization and Past Obstetric and Gynecologic History

Andreasen¹,

Kristoffersen²

1989

Amer J Perinatol

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The influence of the localization of the placenta and some technical problems associated with the performance of amniocentesis (AC) on the incidence of spontaneous abortion (SA) after AC was evaluated in a prospective study comprising all women (2276) referred for AC at the University Hospital in Odense during a 7-year period. Women with predisposing factors for SA were excluded from this analysis, which comprised 1545 women. Of these, 1289 women had an AC and 256 were judged not to need an AC after ultrasonographic examination. The localization of the placenta per se had no influence on the incidence of SA. However, if the placenta was covering the whole anterior wall so that perforation of the placenta could not be avoided, or if more than one insertion was necessary, or there was macroscopic blood contamination in the amniotic fluid, the risk of SA was increased by a factor 4 to 5. The influence of previous obstetric or gynecologic complications on the incidence of SA was also examined. In this analysis the data from women with first trimester hemorrhage in the present pregnancy were included and the study population therefore consisted of 1594 women. Of these, 1318 had an AC, and 276 had ultrasound scanning only. Patients with one or more previous pregnancies with fetal loss had a significantly greater risk of SA after AC than patients with no previous pregnancies or successfully completed pregnancies. Two subgroups with special problems, namely, women with previous complaint of infertility of at least 2 years' duration and women with first trimester bleeding, also had an increased risk of SA.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…In contrast to these studies, [1][2][3] no statistically significant differences in fetal loss rates were found between study and control groups in other controlled studies. [4][5][6]15 In these studies, [4][5][6]15 however, the differences in fetal loss rates between study and control groups were less than 1% and therefore may have not achieved statistical significance because none of these studies had sufficient statistical power to detect differences of less than 1% due to their small sample sizes, as in our study. More than 10,000 patients would be required to allow us to distinguish a statistically significant risk < 1%.…”

Section: Discussionmentioning

confidence: 81%

“…Although some studies reported an increased risk of fetal loss resulting from the procedure, 1-3 others were not able to confirm this finding. 4,5 Factors that could be associated with increased fetal loss rates and have been investigated in the literature include transplacental needle passage, [6][7][8][9] frequency of needle insertion, 5,8 the gauge of the needle, 5 and operator experience. 8,[10][11][12] The purpose of this large case-control study was to investigate whether second-trimester amniocentesis increases the risk of fetal loss.…”

mentioning

confidence: 99%

Pregnancy Outcome Following Second-Trimester Amniocentesis: A Case-Control Study

et al. 2006

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The purpose of this study was to investigate whether second-trimester amniocentesis increases fetal loss rate. Two thousand sixty-eight women with singleton gestations who underwent mid-trimester amniocentesis at 15 to 22 weeks gestation and 2068 controls matched one-to-one for maternal age, parity, and the number of prior spontaneous abortions were studied prospectively in a case-control study design. The fetal loss rates and other adverse pregnancy outcomes were compared between the study and control groups using the Pearson chi2 test or Fisher exact test when appropriate. In the amniocentesis group, eight (0.4%) fetal losses occurred within 30 days of the procedure, and in the control group, six (0.3%) losses occurred within 30 days of the inclusion in the study; the difference was not statistically significant ( p = 0.59; OR, 1.34; 95% CI, 0.46 to 3.85). The total fetal loss rates including spontaneous abortions and intrauterine fetal deaths/stillbirths were 2.3 and 2% in the study and control groups, respectively, and the difference was not significant ( p = 0.59; OR, 1.12; 95% CI, 0.74 to 1.71). Amniotic fluid leakage occurred in only two (0.1%) of 2068 study patients. Transplacental needle passage was not associated with an increased risk of pregnancy loss compared with nontransplacental amniocentesis ( p = 0.92; OR, 0.96; 95% CI, 0.47 to 1.95). There was no statistically significant difference in fetal loss rate between women requiring two needle insertions to obtain amniotic fluid and those having only one insertion ( p = 1.00; OR, 0.75; 95% CI, 0.10 to 5.53). The rates of preterm deliveries, small for gestational age infants, preeclampsia/eclampsia, placental abruptions, and cesarean deliveries were also not significantly different between two groups (each p > 0.05). We conclude that second-trimester amniocentesis for prenatal diagnosis is a safe procedure that does not appear to increase fetal loss rate.

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Reproductive outcome following amniocentesis for genetic indications

Cited by 38 publications

References 13 publications

Transplacental amniocentesis: Is it really a higher‐risk procedure?

Transplacental amniocentesis: Is it really a higher‐risk procedure?

Incidence of Spontaneous Abortion After Amniocentesis: Influence of Placental Localization and Past Obstetric and Gynecologic History

Pregnancy Outcome Following Second-Trimester Amniocentesis: A Case-Control Study

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