The use of ultrasound in evaluating problems and complications of genetic amniocentesis

✍ Scribed by Colin R. McArdle; Wayne Cohen; Carl Nickerson; Lucy E. Hann

• Publisher: John Wiley and Sons
• Year: 1983
• Tongue: English
• Weight: 317 KB
• Volume: 11
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1870110804

✦ Synopsis

A prospective study of 460 midtrimester amniocenteses performed with ultrasonic guidance was made to determine the problems that occur during amniocentesis and the causes of dry or bloody taps. In 27 instances the needle was seen piercing the fetus. Thickening of the uterine wall, tenting of the membranes, and blocking o f flow by the fetus were also observed. The dangers of advancing the needle blindly when no fluid is obtained at the predetermined depth is stressed. The use of active real-time ultrasonic guidance during amniocentesis is advocated. Indexing Words: Ultra- Ultrasound sonics -Amniocentesis * Adverse effects is being increasingly used to guide clinicians performing amniocentesis for the prenatal diagnosis of genetic disorders. This has resulted in a reduction of both the failure to obtain fluid and the aspiration of blood-stained However, even in these reported series, both failed and bloody taps remain common problems. The cause of these problems has not been extensively addressed. It is also well established that injury to the fetus by the needle can occur,6p8 but only by retrospective observations of skin blemishes on the infant rather than direct visualization at the time of the amniocentesis.

In order to further study the causes for both bloody and dry taps and to better establish the potential for fetal injury, we used direct ultrasonic visualization of both the fetus and the needle during amniocentesis in those cases where either no fluid or bloody fluid was obtained. We should like to present the results of this study.

Methods

We studied 460 patients undergoing midtrimester amniocentesis for genetic purposes. These pro-From the Departments of Radiology* and Obstetrics and Gy-