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Assignment On Amniocentesis

This document provides an overview of amniocentesis, including its definition, indications, procedures, precautions, and hazards. Amniocentesis is a procedure where a needle is inserted into the amniotic sac under ultrasound guidance to collect amniotic fluid for diagnostic testing. It can be used to test for genetic disorders, fetal maturity, and complications in pregnancy like fetal distress. While it provides diagnostic benefits, there are also potential maternal and fetal risks like infection, bleeding, premature labor, and fetal loss that require precautions during the procedure.

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960 views4 pages

Assignment On Amniocentesis

This document provides an overview of amniocentesis, including its definition, indications, procedures, precautions, and hazards. Amniocentesis is a procedure where a needle is inserted into the amniotic sac under ultrasound guidance to collect amniotic fluid for diagnostic testing. It can be used to test for genetic disorders, fetal maturity, and complications in pregnancy like fetal distress. While it provides diagnostic benefits, there are also potential maternal and fetal risks like infection, bleeding, premature labor, and fetal loss that require precautions during the procedure.

Uploaded by

suriya prakash
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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ASSIGNMENT ON

AMNIOCENTESIS

SUBMITTED TO: SUBMITTED BY:

DEFINITION:

Amniocentesis is the deliberate puncture of the amniotic fluid sac per abdomen.
INDICATIONS: 

Diagnostic 

Therapeutic

DIAGNOSTIC:

„ Early months (15–20 weeks):

Genetic amniocentesis antenatal diagnosis of chromosomal and genetic

disorders:

(i) Sex-linked disorders.

(ii) Karyotyping.

(iii) Inborn errors of metabolism.

(iv) Neural tube defects.

„ Later months:

(i) Fetal maturity

(ii) Degree of fetal hemolysis in Rh-sensitized mother—Spectrophotometric analysis of amniotic f uid

and deviation bulge of the optical density at 450 nm is obtained

(iii) Meconium staining of liquor—an evidence of fetal distress.

THERAPEUTIC:

„ First half:

(1) Induction of abortion by instillation of chemicals such as hypertonic saline, urea or

prostaglandins.

(2) Repeated decompression of the uterus in acute hydramnios.

„ Second half:

(1) Decompression of uterus in unresponsive cases of chronic hydramnios producing distress

or to stabilize the lie when it is not axial prior to induction.

(2) To give intrauterine fetal transfusion in severe hemolysis following Rh isoimmunization.

(3) Amnioinfusion: Infusion of warm normal saline into the amniotic cavity is done transabdominally or
transcervically to increase the volume of amniotic f uid.
Indications of amnioinfusion:

A. Oligohydramnios—(i) to prevent fetal lung hypoplasia, (ii) to minimize umbilical cord compression
during labor.

B. to dilute meconium-stained amniotic f uid.

PROCEDURE:

(1) After emptying the bladder, the patient remains in dorsal position.

(2) The abdominal wall is prepared aseptically and draped.

(3) The proposed site of puncture is infiltrated with 2 mL of 1% lignocaine.

A 20- or 22-gauge spinal needle with stylet in about 4" in length is inserted into the amniotic
cavity under real-time sonographic control (Fig. 41.12). Injury to the placenta, umbilical cord and fetus is
to be avoided. Continuous visualization of the needle under USG guidance reduces the risks of injury,
bloody or dry tap and need of multiple insertion. The stilette is withdrawn and few drops of liquor are
discarded. Initial 1–2 mL of fluid is either used for AFP or is discarded as it is contaminated with
maternal cells. Rest is used for fetal karyotyping. About 30 mL of f uid is collected in a test tube for
diagnostic purposes. Fetal cardiac motion is to be seen after the procedure. Patient is asked to report for
any uterine cramps, vaginal bleeding or leakage of liquor.

PRECAUTIONS:

(i) Prior sonographic localization of placenta is desirable to prevent bloody tap and fetomaternal

bleeding.

(ii) Prophylactic administration of 100 mg of anti-D immunoglobulin in Rh-negative nonimmunized

mother. Hazards are reduced significantly when it is done “under direct ultrasound control” compared to
the blind procedure.

HAZARDS:

(A) Maternal complications are:

(1) Infection.

(2) Hemorrhage (placental or uterine injury).

(3) Premature rupture of the membranes and premature labor.

(4) Maternal isoimmunization in Rh-negative cases.

(B) Fetal hazards are:

(1) Fetal loss (1 in 400 procedures).


(2) Trauma.

(3) Fetomaternal hemorrhage.

(4) Oligohydramnios due to leakage of amniotic fluid and that may lead to: (i) Fetal lung hypoplasia. (ii)
Respiratory distress. (iii) Talipes. (iv) Amnionitis (rare).

Amniocentesis should be avoided for HIV-positive women and noninvasive tests (NT, MSAFP, anatomic
USG) are preferred. However in women with HBV, HCV may be done with counseling.

Early amniocentesis (11–14 weeks) not to be done for genetic indications as the cell culture failure rate is
high. Less fluid is withdrawn. Rates of complications are high

BIBLIOGRAPHY:

1. Annamma Jocob. A Comprehensive Textbook Of Midwifery And Gynecological Nursing:. Fourth


Edition. New Delhi: Jaypee Brother Medical Publisher (P) Ltd; 2015. Pp (156-157)

2. BT Basavanthappa. Essential Of Midwifery And Obstetrical Nursing:. First Edition. New Delhi: Jaypee
Brothers Medical Publisher (P) Ltd; 2011. Pp (206-207)

3. D.C. Dutta’s. Text Book Of Obstetrics:. Seventh Edition. New Delhi: New Central Book Agency (P)
Ltd; 2010. Pp (153-154)

4. Dr. Shally Magon. Sanju Sira. Textbook Of Midwifery And Obstetrical Nursing: Third Edition. New
Delhi: Lotus Publisher; 2013. Pp (333)

5. Myles. Text Book For Midwives:. Fifth Edition. UK: Churchill Livingstone Elsevier; 1964. Pp (176-
177)

6. Nima Baskar. Midwifery And Obstetrical Nursing:. Seventh Edition. Bangalore: EMMESS Medical
Publisher; 2015. Pp (252-254

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