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’’

INDICATION genetic Lung maturity Infection Hemolytic anemia NTD Coagulopathy Polyhydramnious treatment

Post procedural care Rhogam Discolored sample contamination

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

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

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

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

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