The yield and complications of amniocentesis performed after 24 weeks of gestation

Geffen, Keren Tzadikevitch; Ben-Zvi, Ohad; Weitzner, Omer; Peleg, Amir; Biron‐Shental, Tal; Sukenik-Halevy, Rivka

doi:10.1007/s00404-017-4408-7

Cited by 13 publications

(20 citation statements)

References 22 publications

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“…Sequential systematic reviews (SRs) and meta-analyses (MAs), from 2015 to 2019, provided large data sources for procedure-related fetal loss assessments following intraamniotic diagnostic testing in noninfected diagnostically tested cohorts, generally for a fetal genetic evaluation [9][10][11][12][13][14][15][16][17][18][19]. The SRs/MAs [9,10,17,18] identified the amniocentesis procedure-related fetal loss risk at 0.11-0.35% (1 loss per 290-300 to 900) with a reported control spontaneous fetal loss rate of 0.58-0.67% (no procedure; approximately 1 per 150-170 pregnancies).…”

Section: Questionmentioning

confidence: 99%

“…The evaluation of a "complex pregnancies" cohort requiring amniocentesis after 24 weeks of gestation for a number of indications (perinatal infection, lung maturity, therapeutic procedures, genetic testing) is summarized in Geffen et al [19]. Even though only 7% of the procedures had an infectious indication, the second trimester amniocentesis gestational age of > 24 weeks is important for analysis, as the outcomes are useful for the informed consent process.…”

Section: Questionmentioning

confidence: 99%

“…While the procedure indications were varied, the mean gestational age at amniocentesis was approximately 32 weeks (range 24-37), with 104 procedures at 24-32 weeks and 63 procedures at > 32 weeks. The mean gestational age at delivery was 38.3 weeks (±2.7) and latency from amniocentesis to delivery < 1 week was 7% [19].…”

Section: Questionmentioning

confidence: 99%

“…Invasive diagnostic procedures at > 22-24 weeks of gestation have an increased risk for preterm delivery of 7-8% mainly associated with preexisting fetal congenital and amniotic fluid abnormalities. The possibility of an increased preterm birth mechanism associated with intrauterine viral infection in the late second and third trimester alone has limited data to support this perinatal risk [19,46,47]. Table 3 summarizes the published literature for maternal infection cohorts and the outcomes for unintended fetal loss and evaluations to determine the possibility of fetal VT [48][49][50][51][52][53][54][55][56].…”

Section: Questionmentioning

confidence: 99%

“…The prevalence of maternal-fetal risk with primary exposure to a potential teratogenic viral or nonviral organism is likely to increase due to maternal exposures to infectious scenarios. Infectious exposure during pregnancy has become more frequent and complex due to immigra-DOI: 10.1159/000508042 tion, international travel destinations (ZIKA virus, hepatitis, COVID- 19), increased viral morbidity (H1N1, Ebola), and decreasing population utilization of primary vaccination and annual influenza vaccination for the protection of families/children (rubella, varicella, pertussis) [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Acute Perinatal Infection and the Evidenced-Based Risk of Intrauterine Diagnostic Testing: A Structured Review

Wilson

2020

Fetal Diagn Ther

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Background: The prevalence of perinatal infection from maternal exposure is increasing. The prevalence of acute maternal infections identifies cytomegalovirus, parvovirus B19, toxoplasmosis, and varicella as the most common organisms and in the order of frequency. Maternal informed consent and understanding is required before intrauterine testing for fetal infectious and possible genetic risk assessment. Methods: This structured review of the reproductive published literature focuses on the risks of amniocentesis and cordocentesis diagnostic procedure-related fetal loss rates and fetal vertical transmission (VT) rates from published infected pregnant cohorts. Results: The total postprocedure fetal loss rate for diagnostic amniocentesis procedures, in limited infectious cohorts, is 1.5% and does not appear to be increased compared to "noninfected" amniocentesis cohorts using an estimated background spontaneous fetal loss rate (no procedure) of 0.65%. The "pooled" unintended fetal loss rate is from small infected population cohorts, but can be used for counseling purposes. Postcordocentesis fetal loss risk, in an infected cohort, is not possible to estimate due to limited data. The "biological spontaneous fetal loss rate" risk with a perinatal infection (positive or negative fetal anomalies) and no diagnostic procedure before 20 weeks of gestation is reviewed. The risk of VT in acute infection cohorts as a result of the intra-amniotic diagnostic procedure is not found to be increased. Conclusion: The unintended "fetal loss" rate after amniocentesis for perinatal infected cohorts is similar to that of noninfected cohorts, but the estimate is based on limited infected cohorts. There was no procedure-based risk of fetal VT in the infected cohorts, but identification of postprocedure maternal bleeding into the amniotic cavity increases the potential risk. Maternal knowledge translation and an informed consent process with risk-benefit maternal/fetal risk counseling are required prior to any diagnostic amniocentesis procedure.

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Section: Questionmentioning

confidence: 99%

Section: Questionmentioning

confidence: 99%

Section: Questionmentioning

confidence: 99%

Section: Questionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Acute Perinatal Infection and the Evidenced-Based Risk of Intrauterine Diagnostic Testing: A Structured Review

Wilson

2020

Fetal Diagn Ther

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Obstetrical outcomes following amniocentesis performed after 24 weeks of gestation: A systematic review and meta‐analysis

Nassr,

Hessami,

D’Alberti

et al. 2023

Prenatal Diagnosis

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To evaluate obstetrical outcomes for women having late amniocentesis (on or after 24 weeks). Electronic databases were searched from inception to January 1st, 2023. The obstetrical outcomes evaluated were gestational age at delivery, preterm birth (PTB) < 37 weeks, PTB within 1 week from amniocentesis, premature prelabor rupture of membranes (pPROM), chorionamnionitis, placental abruption, intrauterine fetal demise (IUFD) and termination of pregnancy (TOP). The incidence of PTB <37 weeks was 4.85% (95% CI 3.48–6.56), while the incidence of PTB within 1 week was 1.42% (95% CI 0.66–2.45). The rate of pPROM was 2.85% (95% CI 1.21–3.32). The incidence of placental abruption was 0.91% (95% CI 0.16–2.25), while the rate of IUFD was 3.66% (95% CI 0.00–14.04). The rate of women who underwent TOP was 6.37% (95%CI 1.05–15.72). When comparing amniocentesis performed before or after 32 weeks, the incidence of PTB within 1 week was 1.48% (95% CI 0.42–3.19) and 2.38% (95% CI 0.40–5.95). Amniocentesis performed late after 24 weeks of gestation is an acceptable option for patients needing prenatal diagnosis in later gestation.

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Amniocentesis in twin gestation: the association between gestational age at procedure and complications

Wertheimer

Decter

Borovich

et al. 2021

Arch Gynecol Obstet

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The yield and complications of amniocentesis performed after 24 weeks of gestation

Cited by 13 publications

References 22 publications

Acute Perinatal Infection and the Evidenced-Based Risk of Intrauterine Diagnostic Testing: A Structured Review

Acute Perinatal Infection and the Evidenced-Based Risk of Intrauterine Diagnostic Testing: A Structured Review

Obstetrical outcomes following amniocentesis performed after 24 weeks of gestation: A systematic review and meta‐analysis

Amniocentesis in twin gestation: the association between gestational age at procedure and complications

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