1. Amniocentesis
First introduced by Serr and Fuchs and Riis in the 1950s for fetal sex determination
Only at the late 70th a static ultrasound was used to locate the placenta and amniotic fluid pocket
Only In 1983, Jeanty reported a technique of amniocentesis ’’under ultrasound vision’’

2. INDICATION genetic Lung maturity Infection Hemolytic anemia NTD
Coagulopathy
Polyhydramnious treatment

6. Post procedural care Rhogam Discolored sample contamination

7. complications Pregnancy loss 0.3-1.0%. Increase risk:
Needle larger than 18g
Multiple needle insertion
Discoloration of the fluid
High AFP, multiple late abortions, previous vaginal bleeding
Placental perforation – recent studies didn’t find correlation

8. Complications Leakage of amniotic fluid Amnionitis:HCV, CMV, TOXO ,HIV
Vaginal bleeding
Fetal injury
Long term complications:
Respiratory distress?
Isoimmunization?

9. Amniocentesis and HIV positive women
Increased rate of vertical transmission
Chemoprophylaxis previous to amniocentesis appears to be beneficial in preventing vertical transmission

10. Multiple Gestation Three methods:
Indigo carmine injection to the first sac
A single needle puncture sampling technique (Jeanty 1990)
Simultaneous visualization of two needles on each side of the separating membrane (Bahado-Singh 1992)
Abortion risk – probably higher
Detailed description of fetus position and placental location

11. Thank you