Amniocentesis is a safe and effective prenatal diagnostic tool: a clinical study in Eastern India
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20150705Keywords:
Prenatal diagnosis, Amniocentesis, MiscarriageAbstract
Background: Aim of current study was to estimate the benefits of amniocentesis for diagnosis of fetal chromosomal abnormalities as well as the risk of miscarriage in Indian women and thus provide local data for counselling the prospective parents contemplating amniocentesis.
Methods: This retrospective study reviewed the miscarriage rate of 243 pregnant women who underwent midtrimester amniocentesis for prenatal diagnosis of fetal chromosomal abnormalities. 20 ml of amniotic fluid was aspirated under ultrasound guidance.
Results: Only three women had miscarriage, two of them within a week of the procedure and the other one after two weeks. The miscarriage rate in this study was 1.23% which was not statistically significantly different from the miscarriage rate found in a large trial, faster trial, taken as reference.
Conclusions: Two factors, indications for amniocentesis as well as the procedure itself, contribute to the risk of miscarriage. The procedure-related risk is very low and the total risk of miscarriage is around one percent. Amniocentesis is a safe and effective prenatal diagnostic procedure.
References
Divane A, Carter NP, Ferguson-Smith MA. Rapid prenatal diagnosis from uncultured amniotic fluid cells using five-color fluorescence in situ hybridization. Prenatal Diagn. 1994;14:1061-9.
Whiteman DAH, Klinger K. Efficiency of rapid in situ hybridization methods for prenatal diagnosis of chromosomal abnormalities causing birth defects. Am J Hum Genet. 1991;(Suppl 49):A1279.
Eddleman KA, Malone FD, Sullivan L, Dukes K, Berkowitz RL, Kharbutli Y, et al. Pregnancy loss rates after midtrimester amniocentesis. Obstet Gynecol. 2006;108:1067-72.
Steele MW, Breg W Jr. Chromosome analysis of human amniotic-fluid cells. Lancet. 1966;1:383-5.
Tabor A, Philip J, Madsen M, Bang J, Obel EB, Nørgaard-Pedersen B. Randomised control trial of genetic amniocentesis in 4606 low-risk women. Lancet. 1986;1(8493):1287-93.
Byrne D, Marks K, Azar G, Nicolaides K. Randomized study of early amniocentesis versus chorionic villus sampling: a technical and cytogenetic comparison of 650 patients. Ultrasound Obstet Gynecol. 1991;I:235-40.
Karaoguz MY, Bal F, Yakut T, Ercelen NO, Ergun MA, Gokcen AB, et al. Cytogenetic results of amniocentesis materials: incidence of abnormal karyotypes in the Turkish collaborative study. Genet Counsel. 2006;17:19-30.
Tseng JJ, Chou MM, Lo FC, Lai HY, Chen MH, Ho ES. Detection of chromosome aberrations in the second trimester using genetic amniocentesis: experience during 1995-2004. Taiwan J Obstet Gynecol. 2006;45:39-41.
Odibo AO, Gray DL, Dicke JM, Stamilio DM, Macones GA, Crane JP. Revisiting the fetal loss rate after second-trimester genetic amniocentesis. Obstet Gynecol. 2008;111:589-95.
Tabor A, Vestergaard CHF, Lidegaard Ø. Fetal loss rate after chorionic villus sampling and amniocentesis: an 11-year national registry study. Ultrasound Obstet Gynecol. 2009;34:19-24.
Wilson RD. Randomised trial to assess safety and fetal outcome of early and midtrimester amniocentesis. The Canadian Early and Mid-trimester Amniocentesis Trial (CEMAT) Group. Lancet. 1998;351:242-7.
Akolekar R, Beta J, Picciarelli G, Ogilivie C, D’Antonios F. Procedure-related risk of miscarriage following amniocentesis and chorionic villus sampling: a systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2015;45:16-26.
Ogilivie C, Akolekar C. Pregnancy loss following amniocentesis or CVS sampling - time for a reassessment of risk. J Clin Med. 2014;3:741-6.
Akolekar R, Bower S, Flack N, Bilardo CM, Nicolaides KH. Prediction of miscarriage and stillbirth at 11-13 weeks and the contribution of chorionic villus sampling. Prenatal Diagn. 2011;31:38-45.
Wilson RD, Langlois S, Johnson JA. Mid-trimester amniocentesis fetal loss rate. J Obstet Gynaecol Can. 2007;29:586-95.
Alfirevic Z, Mujezinovic F, Sundberg K. Amniocentesis and chorionic villus sampling for prenatal diagnosis. Cochrane Database Sys Rev. 2003;3:9,12.