Antenatal diagnosis of genetic disease / edited by A.E.H. Emery.

Date:
1973
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Antenatal diagnosis of genetic disease / edited by A.E.H. Emery. Source: Wellcome Collection.

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    3 Amniocentesis: Technique and Complications J. B. SCRIMGEOUR Amniocentesis is the technique by which a sample of amniotic fluid is aspirated from the amniotic sac. Research in relatively recent years has shown that from the study of amniotic fluid and its contained cells fetal wellbeing may be assessed. Such studies have inevitably led to an increase in the number of indications for amniocentesis. Depending on the indication and diagnosis expected from the amniotic fluid, amniocentesis may be required at virtually any stage in pregnancy from ten weeks gestation to beyond term. This must therefore be regarded as a direct challenge to the obstetrician to perfect the technique of amniocentesis as far as possible, so that minimal complications occur in mother and fetus, immaterial of what stage of gestation the procedure is carried out. An equal, but related challenge is to ensure that the specimen of liquor reaches the laboratory uncontaminated by skin, bacteria or blood of maternal or fetal origin. Emphasis must be placed on the normal variation of the amnio¬ tic fluid content at any specific period of gestation and the varia¬ tion which so often occurs in the course of normal pregnancy. These variables make it imperative that amniocentesis be carried out both at a gestation when normal values are already known and that the investigation can be carried out reliably by the laboratory concerned, using a technique familiar to that labora¬ tory and on which the normal range was based. In any specific case a broad explanation of the procedure should be made to the patient, underlining the advantage that the examination of the liquor would have in her particular case, and a consent form for amniocentesis should then be signed by the patient (see Fig. 1). It follows that the result obtained from the study of the amniotic fluid should be acted on. Should no action be contemplated, whatever the result, it is doubtful whether amniocentesis is justified in the first instance.