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Amniocentesis
Description
Amniocentesis is the sampling of fluid from around the growing fetus for prenatal biochemical or genetic diagnosis. For these purposes, amniocentesis is being replaced by chorionic villus sampling and cell-free DNA analysis. Amniocentesis may rarely be used to reduce the amount of amniotic fluid present in cases of polyhydramnios.
Indications
This procedure is used for assessing fetal genetics or metabolic disorders, fetal infection, or isoimmunization status. Amniocentesis for the assessment of fetal lung maturity was once common but is rarely performed now. Cell-fee DNA studies are also supplanting much of the need for genetic amniocentesis. Therapeutic amniocentesis may be performed for reducing the fluid volume or instilling agents for fetal therapy or other purposes such as fetal imaging or diagnosing the rupture of fetal membranes. Amniocentesis is also a necessary step in other diagnostic and therapeutic procedures such as cordocentesis or fetal transfusion.
Contraindications
Active skin infections near the site of needle placement. Relative; maternal fever of unknown origin, known or suspected allergies to materials used (eg, latex, skin preparation materials, local anesthetics), and uncorrected coagulopathy. Although technically possible as early as 11 weeks gestation, higher rates of fetal loss suggest that early amniocentesis should be delayed until or after 15–17 weeks. Amniocentesis may be technically difficult to accomplish in patients with multiple gestations.
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