The risk of second-trimester amniocentesis in twin gestations: A case-control study

Ghidini, Alessandro; Lynch, Lauren; Hicks, Casandra; Álvarez, Manuel; Lockwood, Charles J.

doi:10.1016/0002-9378(93)90045-k

Cited by 91 publications

(47 citation statements)

References 15 publications

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“…In the present study, the chromosomal anomalies rate (3.0%) was comparable to other studies [19][20] . The study population was biased by the exclusion of obvious fetal anomalies on ultrasound at the time of the amniocentesis.…”

Section: Discussionsupporting

confidence: 79%

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Amniocentesis for Twin Pregnancies: Is Alpha-Fetoprotein Useful in Confirming that the Two Sacs Were Sampled?

Delisle

Wilson²

2007

Fetal Diagn Ther

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Objective: To assess if amniotic fluid alpha-fetoprotein (AFAFP) could be useful to determine if both sacs are sampled during an amniocentesis for twin pregnancies. Method: We reviewed all amniocenteses performed on twin pregnancies over a 5-year period. Inclusion criteria were restricted to pregnancies where both karyotypes and AFAFP were available on each fetus. Pregnancies complicated by fetal anomalies were excluded. The following information was obtained: maternal age, gestational age at the procedure, karyotypes, AFAFP values, pregnancy and neonatal outcome. Placental pathology reports were used to confirm chorionicity. Analysis was performed to evaluate the impact of the fetal gender and chorionicity on the AFAFP values. Results: 260 pregnancies were reviewed. Mean maternal age was 36.9 years (33.6, 40.1). Gestational age at the time of the procedure was 16.2 weeks (14.5, 17.9). Complications included 1.8% of misdiagnosis (discrepancy between karyotype and gender). The difference of AFAFP values between the two fetuses was statistically larger in dichorionic pregnancies than in monochorionic gestations. Fetal gender had no influence on the AFAFP. Conclusion: Amniocentesis in twin pregnancies is associated with a 1.8% risk of misdiagnosis. AFAFP can help to assess the chorionicity of a twin pregnancy. When the difference between the two values is <0.2 MoM and the chorionicity was thought to be dichorionic and the two karyotypes are similar, then failure to sample both sacs should be suspected.

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Section: Discussionsupporting

confidence: 79%

“…Some authors found an increased fetal loss [2, 10-17] others did not [18][19][20] . Yukobowich et al [21] described a loss rate of 2.73% in his series of 476 twin amniocenteses.…”

Section: Discussionmentioning

confidence: 99%

Amniocentesis for Twin Pregnancies: Is Alpha-Fetoprotein Useful in Confirming that the Two Sacs Were Sampled?

Delisle

Wilson²

2007

Fetal Diagn Ther

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“…Many studies have reported on the pregnancy loss rate after amniocentesis in twins (11)(12)(13)(14)(15)(16)(17)(18). However, there are no data concerning the risk of the procedure in twins conceived after ART.…”

mentioning

confidence: 96%

Second trimester amniocentesis in assisted conception versus spontaneously conceived twins

Anastasakis¹,

Papantoniou²,

Mesogitis³

et al. 2009

Fertility and Sterility

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“…The results were highly dependent on the size of the sample. Ghidini et al [13] found in a randomized prospective study of 100 pregnancies that amniocenteses had not increased the incidence of spontaneous abortions in multiple pregnancies. Very little reliable data are available regarding spontaneous fetal loss in multiple pregnancies.…”

Section: Discussionmentioning

confidence: 99%

“…Several reports have been published about the effects of genetic amniocentesis on fetal loss in multiple pregnancies over the past two decades. Data concerning fetal loss are found to exhibit a very wide range [12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Genetic Amniocentesis in Multiple Pregnancy

et al. 2004

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Objectives: Second-trimester genetic amniocentesis is the most frequently used invasive prenatal diagnostic technique. Several reports have been published about the effect of genetic amniocentesis on fetal loss in multiple pregnancies over the past two decades. Here we analyze our experience with genetic amniocentesis in multiple pregnancies over the past 10 years. Methods: Details of 184 multiple pregnancies were processed in all cases in whom genetic amniocentesis was performed in women who presented at our department since 1990. The outcomes of 175 cases (95.1%) out of 184 genetic amniocenteses were available to us. As a control group, we followed up the outcome of 300 twin pregnancies in which no genetic amniocenteses were performed. Results: We found that the proportion of spontaneous losses in multiple pregnancies between the 18th and the 24th gestational weeks was 2.39%, whereas if genetic amniocentesis was performed the loss rate before the 24th week was 3.87%. The perinatal mortality rate was 10.03/1,000 in the group who underwent amniocentesis, while it was 10.52/1,000 in the group without amniocentesis. Conclusions: Our results suggest that the genetic amniocentesis performed in multiple pregnancies slightly increased (1.48%) the fetal loss rate until the 24th week. Beyond 5 weeks after the procedure, no consequent fetal loss should be expected. In our study the intervention did not have any undesired effect on perinatal mortality rates.

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The risk of second-trimester amniocentesis in twin gestations: A case-control study

Cited by 91 publications

References 15 publications

Amniocentesis for Twin Pregnancies: Is Alpha-Fetoprotein Useful in Confirming that the Two Sacs Were Sampled?

Amniocentesis for Twin Pregnancies: Is Alpha-Fetoprotein Useful in Confirming that the Two Sacs Were Sampled?

Second trimester amniocentesis in assisted conception versus spontaneously conceived twins

Genetic Amniocentesis in Multiple Pregnancy

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