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Amniotic Fluid Interventions and Examinations

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An amniotic fluid examination is required during pregnancy. Read below to learn in detail about the same.

Medically reviewed by

Dr. Richa Agarwal

Published At February 27, 2023
Reviewed AtMarch 27, 2023

Introduction:

Amniotic fluid is the fluid around the fetus (developing baby in the womb). Amniotic fluid interventions and examinations are known as amniocentesis. In this procedure, amniotic fluid is withdrawn for various tests to diagnose problems with the developing baby.

What Is Amniocentesis?

A medical professional performs amniocentesis to collect a sample of the amniotic fluid for analysis. Cells and other chemicals present in the fluid provide information about the baby's health. The results are very precise. If prenatal (before birth) screenings indicate genetic problems or birth abnormalities in an infant, the healthcare practitioner or obstetrician recommends amniocentesis. Amniocentesis can also reveal the gender of the unborn child, detect infections during pregnancy, and assess lung development.

What Is Amniotic Fluid?

The amniotic sac (the membrane that contains the fetus) contains a protective fluid for developing babies, known as amniotic fluid. During labor, the "water breaks," and the amniotic sac ruptures and releases the fluid. The liquid is transparent and a subtle yellow. It performs various functions, such as:

  • It maintains the temperature.

  • The infant receives padding from it.

  • It assists in lung development by flowing into and out of the infant's mouth and lungs.

  • It enables infant movements, which promotes bone development.

What Is the Right Time for Amniotic Fluid Interventions and Examinations?

The typical window for genetic amniocentesis is between 14 and 20 weeks of pregnancy. However, before 14 weeks of pregnancy, amniocentesis may result in further difficulties. It usually takes 15 minutes to 20 minutes to complete the procedure.

What Are the Reasons for Performing Amniotic Fluid Interventions and Examinations?

  • Genetic Analysis - Information about the baby's genes can be obtained through genetic amniocentesis. Genetic amniocentesis is typically used when test results affect the management of pregnancy. Consider performing genetic amniocentesis for the following reasons:

  1. If the screening tests reveal a disorder with a high-risk level, amniotic fluid samples are taken during genetic amniocentesis. The deoxyribonucleic acid (DNA) from the cells is used to diagnose disorders like Down syndrome.

  2. The doctor may advise amniocentesis when an anomaly (abnormality in the developing baby) is found during an ultrasound during pregnancy.

  3. If the parents are genetic carriers or have a history of genetic disorders in the family.

  4. A prenatal screening test reveals an elevated risk for chromosomal disease (a disease due to a gene problem).

  5. When the pregnant woman is over 35 when the baby is born, she is more likely to give birth to a child with a chromosomal abnormality.

  • Fetal Infections Identified - Amniocentesis may occasionally be performed to check the baby for infections or other illnesses.

  • Treatment Purpose - Amniocentesis may be performed to remove excessive buildup of amniotic fluid (a condition known as polyhydramnios) from the uterus.

  • Fetal Lung Examination - A baby's amniotic fluid may be analyzed if delivery is anticipated before 39 weeks of pregnancy to determine whether the baby's lungs have developed properly for birth.

What Are the Risks Associated With Amniocentesis?

Risk happens in 1 in 900 procedures and consists of the following:

  • Amniotic Fluid Leakage - Amniotic fluid occasionally escapes through the vagina after performing amniocentesis. Most of the time, the fluid loss is minimal, stops after a week, and has no impact on pregnancy.

  • Miscarriage - The risk of miscarriage after second-trimester amniocentesis ranges from 0.1 percent to 0.3 percent when performed by a qualified ultrasonography technician. Amniocentesis performed before 15 weeks of pregnancy may increase the chance of pregnancy loss, according to research.

  • Needle Wound - The infant may extend an arm or leg into the needle's path during amniocentesis. Significant needle injuries are uncommon.

  • Sensitivity to Rh - Rarely, blood cells from the unborn child may enter the pregnant woman's bloodstream due to amniocentesis. After amniocentesis, individuals with Rh-negative blood who have not yet produced antibodies against Rh-positive blood called Rh immunoglobulin injection (blood product). Crossing the placenta stops the body from producing Rh antibodies that could harm the developing baby's red blood cells.

  • Infection - Amniocentesis may very rarely result in uterine infection.

  • Transmission of an Infection - During an amniocentesis, a person with an infection, such as hepatitis C, toxoplasmosis, or HIV (human immunodeficiency virus) /AIDS (acquired immunodeficiency syndrome), may pass it on to the fetus.

How to Prepare for Amniocentesis?

Amniocentesis for the second trimester is often performed between weeks 15 and 20 of your pregnancy. The actual test takes a few minutes to complete.

  • Before the Test - Pregnant women must have an empty bladder when the test is being performed. The patient should arrive early enough to check in before the start of the amniocentesis procedure. Women should wear clothes that are easy to take off before the exam. Jewelry and other valuables should be left at home.

  • During the Test - The patient must lie on their back for the test. An ultrasound is used by the medical professional to locate the baby and choose an appropriate insertion point for the needle. The doctors may apply numbing agent at the site of insertion. Then the doctor will draw some fluid using a small needle. Doctors will continue to perform the ultrasound to check for the baby's heartbeat after they receive the sample. The patient may experience some discomfort or cramps during or after the procedure. At any point, the patient should express their concerns to the healthcare professional.

  • Following the Test- Afterward, the patient can remain at the testing location for roughly an hour. The doctors do this to monitor both the mother and the infant. If the patient feels queasy or dizzy, the doctor will examine it. After the procedure, the patient is advised to take rest. The patient is advised not to exert themselves for roughly 24 hours following the test. The doctor may suggest medication for any residual discomfort. The patient should approach the doctor if they face problems such as bleeding from the vagina or the site of needle insertion, amniotic fluid leakage, severe cramps or discomfort in the stomach, cold or fever, and alterations in the baby's level of activity.

What Do the Results of Amniocentesis Suggest?

  • Normal Result - If the test result is normal, then the unborn child most likely has no genetic or chromosomal problems.

  • Abnormal Result - Abnormal results indicate a chromosomal anomaly or genetic issue. Therefore, to know more details, additional diagnostic tests may be performed.

The patient should be quick to approach the healthcare professional in case of any questions about what the results may indicate. Doctors can also assist in deciding what to do next in case of abnormal results.

Conclusion:

Women can get assistance in understanding amniocentesis results from their doctor or a genetic counselor. Test findings for genetic amniocentesis can rule out or identify certain genetic disorders, such as Down syndrome. However, not all genetic disorders and birth abnormalities can be detected through amniocentesis. A family may need to make difficult choices if an amniocentesis reveals that the baby has a chromosomal or genetic problem that cannot be treated. Seek out the assistance of the medical team to gain more understanding and further related consequences.

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Dr. Richa Agarwal
Dr. Richa Agarwal

Obstetrics and Gynecology

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