Amniocentesis

Description:

Amniocentesis — the invasive procedure consisting in a puncture of an amniotic cover for the purpose of receiving amniotic waters for the subsequent laboratory research, an amnioreduktion  or introduction to an amniotic cavity of medicines. Amniocentesis can be carried out in the first, second and third trimesters of pregnancy (it is optimum — in 16-20 weeks of pregnancy).

Indications to amniocentesis:
    * Prenatal diagnosis of inborn and hereditary diseases. Laboratory diagnosis of inborn and hereditary diseases is based on the cytogenetic and molecular analysis of amniotsit.
    * Amnioreduktion (at a hydramnion).
    * Intraamnialny administration of drugs for abortion in the second trimester.
    * Assessment of a condition of a fruit in the second and third trimesters of pregnancy (severity of a hemolitic disease, a maturity of surfactants of lungs, diagnosis of pre-natal infections).
    * Fetoterapiya.
    * Fetokhirurgiya.

Contraindications to amniocentesis:
Acute process or aggravation of a chronic inflammation of any localization.

Technology of amniocentesis.
Under ultrasonic control choose the place of a puncture. It is vneplatsentarno preferable to carry out a puncture, in the greatest pocket, free from umbilical cord loops. If the needle needs to be entered transplatsentarno, choose the thinnest site of a placenta which does not have expanded mezhvorsinkovy spaces. Amniocentesis is carried out by means of the needles having diameter 18-22G. Technically amniocentesis is made by method of "a free hand" or with use of the puncture adapter placed on the convex abdominal sensor. Its use allows to control a trajectory of the movement and depth of immersion of an aspirating needle by means of the route on the monitor screen. Having convinced that the needle after a puncture is located in a cavity of a bag of waters, from it extract mandrin, attach the syringe and aspirate necessary amount of amniotic waters. After that again place mandrin in a needle gleam and delete it from a cavity of the uterus. After the end of a procedure carry out assessment of a condition of a fruit (existence and frequency of its heartbeat). When performing amniocentesis in the third trimester of pregnancy recommend performance of monitor observation of a condition of a fruit. According to indications carry out the keeping therapy, an intraoperative antibiotikoprofilaktika and/or therapy.

Amniocentesis complications.

    * Premature izlity amniotic waters.
    * Perhaps short-term dribble of a small amount of OV within the first days after operation (in 1-2% of cases).
    * Amotio of fetal membranes.
    * Infection (the second trimester of pregnancy owing to the low level of antibacterial activity of amniotic waters is most adverse concerning infection).
    * Development of an alloimmune cytopenia in a fruit.