Single-Needle Insertion: An Alternative Technique for Early Second-Trimester Genetic Twin Amniocentesis

Abstract

Single-needle insertion as an alternative technique for genetic amniocentesis in twin gestation has been evaluated in 27 pregnancies. A 22-gauge needle was inserted into the most proximal sac and amniotic fluid was aspirated. The needle was then traversed through the dividing membrane to enter the second sac and amniotic fluid was aspirated. This technique avoids the use of dye and ensures tapping of both sacs. No fetal losses attributable to the procedure occurred during the trial. In comparison with the double-needle insertion, it is a swift and easy procedure and reduces discomfort to the patient.

Outcome of twin pregnancies after amniocentesis

“…9,10 Practice has also changed over time, with greater use of dye injection in the early reports, 2,3,5,11-14 bigger size of needle, and amniocentesis performed in earlier gestation. [2][3][4]8,9,[15][16][17] Tables 3 and 4 show the outcomes of multiple pregnancies after amniocentesis and CVS, quoted from studies published in the last 20 years. Earlier reports described the spontaneous abortion rate up to 28 weeks.…”

Second trimester amniocentesis in assisted conception versus spontaneously conceived twins

“…However, the procedure-related risk (losses within 4 weeks after amniocentesis) was 3% in the former and 2.9% in the latter group. Although a lower fetal loss rate using the single-needle insertion technique has been reported (26,27), we used two separate entries in all cases. We believe that the fetal loss rate is mainly attributed to the route of entry (transplacental or not) rather than the number of punctures.…”

Amniotic Septostomy for the Treatment of Twin Oligohydramnios-Polyhydramnios Sequence

“…In the present series, no disruption of the intervening membrane or entanglement of umbilical cord was detected at the time of delivery. In addition, there are at least three reported series using single needle amniocentesis for genetic diagnosis in twins without complications related to disruption of the intervening membrane [37][38][39].…”