Fredrick H. Creutzmann, M.D. at www.DrCmd.com
Obstetrics, Gynecology and Infertility
4333 North Josey Lane
Plaza 11, Suite #305
Carrollton, Texas 75010
AMNIOCENTESIS
Amniocentesis is the removal of fluid from the amniotic sac (bag of waters).
DESCRIPTION OF PROCEDURE
The main objective of amniocentesis is to obtain amniotic fluid from within the uterus, using a hollow needle carefully inserted into the abdomen. The surgeon will first inject a local anesthetic into the skin where the needle will be inserted. The hollow needle measures about 3 1/2 inches in length. It will be inserted into the skin of the abdominal wall, then through the muscle layer of the uterus, and into the cavity of the uterus. A small amount of fluid, less than an ounce, will then be removed by suction to send to the laboratory for examination. The needle will cause some pain when it penetrates the uterus, but the pain should not last long and should not hurt worse than an injection into any other part of your body. After the fluid removal has been accomplished, the removal of the needle should cause no further discomfort.
Simultaneously during the procedure, ultrasonography (a harmless and painless procedure using high-amplitude sound waves to outline objects inside the body) provides guidance for the needle, to prevent it from harming the unborn child. Ultrasonography also provides new, additional information. Major malformations of the fetus, the presence of twins, and the age of the fetus can be determined from the screen that reflects the image of the ultrasound waves.
When amniocentesis is being performed to diagnose possible congenital abnormalities, most authorities recommend doing it between the 15th and 18th weeks of pregnancy. At this time, there is ample fluid available for testing and enough time remaining for termination of the pregnancy if you and those closest to you decide on that course.
Occasionally, amniocentesis is performed in late pregnancy, to determine maturity and other conditions of the unborn child.
Try to be calm and relaxed before the procedure. Sedative and pain medicines, which may be customary before other minor surgical procedures, will be withheld in this one to ensure the safety of your unborn child.
LABORATORY STUDIES. The laboratory will perform the following studies on the sample of amniotic fluid.
1. The alpha-fetoprotein level in the amniotic fluid will be checked. An elevation beyond normal limits may suggest one of several abnormalities, such as failure of the spinal cord to close, failure of the abdomen to close, or obstruction in the gastrointestinal or urinary systems.
2. Cells, which are always present in amniotic fluid, will be collected and grown in tissue culture to check them for abnormalities of the chromosomes.
3. Tests will be performed that can identify many inborn errors of metabolism.
4. Biochemical (L/S ratio) testing will determine maturity of the fetus.
SAFETY AND RISKS
In the medical literature, authors give varying estimates of the risks of amniocentesis. Some estimate that 1 out of every 100 procedures will initiate an unwanted abortion of the pregnancy. Others report much less of a risk, such as 1 in 150. But you should be aware of this risk, to help you decide whether to have the procedure performed or not.
SITUATIONS THAT MAY JUSTIFY THE RISK.
1. A previous child with a chromosome abnormality (such as Down's syndrome).
2. Mother's age over 35 years.
3. Either parent with a known chromosome abnormality.
4. Mother with a sex-linked abnormality (such as hemophilia, that affects only sons). The purpose of the amniocentesis would be to tell the sex of the baby.
There are other reasons that may apply uniquely to you. You and your medical advisors must decide together what seems to be the wisest decision.
The vast majority (over 95 percent) of tests performed in amniocentesis disclose no abnormalities. Some couples at high risk may desire to have the procedure done so that they will be less anxious during the pregnancy, if the tests show no abnormalities. However, a normal amniocentesis cannot guarantee a normal child; we have no way at present to test for all abnormalities. If the tests do disclose an abnormality, and you and your husband decide not to terminate the pregnancy, then the procedure will enable you to plan for the future and to look for ways to help you cope.
IMPORTANT POINTS FOR POST-PROCEDURE CARE
ACTIVITY. You should be able to return to all your normal activities within a few hours after the procedure. Stay as active as your health and feelings of well-being allow.
DIET. There are no dietary restrictions relating to the procedure. MEDICATIONS. You will be given no medication following this procedure. GENERAL MEASURES
1.You may shower or bathe as usual right afterwards.
2. Don't smoke cigarettes.
3. Continue to avoid all drugs and alcoholic beverages.
CALL OUR OFFICE IF YOU:
1. Get a fever.
2. Feel nauseated and you vomit twice.
3. Experience any unusual lower abdominal pain.
4. Have pain in the shoulder.
5. Notice vagina bleeding.
IF YOU HAVE ANY OTHER QUESTIONS,
PLEASE, DON'T HESITATE TO CALL MY OFFICE.