Amniocentesis
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What is the test?
Amniocentesis involves using a needle to take a sample of amniotic
fluid, the fluid that surrounds a developing fetus during pregnancy.
Tests of fetal cells found in this fluid can reveal the presence
of Down syndrome or other chromosome problems in the baby. Amniocentesis
can also show whether the lungs of the baby are mature enough
to allow it to survive if it were elivered right away.
Amniocentesis is often recommended for pregnant women over age
35, women who have an abnormal “triple screen” blood
test during pregnancy, or women who have (or whose husbands have)
a family history of certain diseases or birth defects.
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How do I prepare
for the test?
You should have a serious discussion with your obstetrician
regarding whether to have amniocentesis. Amniocentesis may be
done anytime between the 14th and 20th weeks of pregnancy to
test for fetal abnormalities. To check on fetal lung development,
the test may be done late in the third trimester.
Tell your doctor ahead of time if you have ever had an allergic
reaction to lidocaine or the numbing medicine used at the dentist's
office.
Just before the test, you should empty your bladder.
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What happens
when the test is performed?
You wear a hospital
gown and lie on your back on a table. An ultrasound is done
to show the location of the fetus and placenta. Your lower
abdomen is cleaned with an antibacterial soap. In some cases,
the doctor uses a small needle to inject a numbing medicine
just under the skin, so you do not feel the amniocentesis sampling
needle later. (Because the sampling needle does not cause much
more stinging than the numbing medicine itself, not every doctor
includes this step.)
The hollow sampling needle is several inches long and is inserted
through the skin and abdominal muscle and then through the wall
of the uterus. A syringe attached to the needle is used to collect
a sample of fluid.
The baby's heart tones and the mother's blood pressure and heart
rate are checked at the beginning and end of the procedure. The
whole procedure takes close to 30 minutes.
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What risks are
there from the test?
Most women experience a few hours of mild pelvic cramping,
and a few will have slight vaginal bleeding. About 1 in 100 women
will have a temporary leak of amniotic fluid through the vagina;
this usually causes no problem.
There is a small risk of miscarriage associated with amniocentesis;
this occurs in about 1 in every 200 to 400 cases, depending in
part on the timing of the test and the experience level of the
physician performing it. Other risks (such as infection or injury
to the fetus that does not cause miscarriage) are extremely rare.
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Must
I do anything special after the test is over?
If the test confirms
that you are Rh incompatible with the fetus, you will need
to receive an injection of a medicine called Rh immune globulin
(Rhogam) to protect the baby from complications.
Let your doctor know immediately if you are having any vaginal
bleeding, fluid leakage, or strong abdominal pain.
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How
long is it before the result of the test is known?
Chromosome analysis
of the fluid sample takes two weeks or more. The results of
some tests may be available sooner.
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