How to perform an amniocentesis.

Abstract

Amniocentesis is a technique for withdrawing amniotic fluid from the uterine cavity using a needle, via a transabdominal approach and under continuous ultrasound guidance, in order to obtain a sample of fetal exfoliated cells, transudates, urine or secretions. It can be performed from 16 weeks of pregnancy onwards, with various chromosomal, biochemical, molecular and microbial studies being performed on the amniotic fluid sample. The most common reasons for the procedure are to enable prenatal diagnosis of chromosomal abnormalities, single gene disorders, fetal infection and intra-amniotic inflammation, as well as to assess fetal lung maturity and blood or platelet type. The procedure has a risk of fetal loss of approximately 0.5% (range, 0.06–1%)1 when performed in the second trimester, after the amniotic membrane has fused with the chorion; there is also a risk of amniotic fluid leakage (approximately 0.3% of cases) and other rare complications, such as placental hemorrhage, intra-amniotic infection, abdominal wall hematoma and fetal lesion. There is an important lack of good-quality evidence to support most recommendations for the procedure, and a recent review suggested that operators should use those methods and technique modifications with which they are most familiar when performing an amniocentesis2. The aim of this summary article and the full version, included as supplementary material online, is to describe the amniocentesis technique, presenting a practical guideline for its performance. We also describe the use of a Vacutainer® (BD Vacutainer Systems, Plymouth, UK) aspiration system in order to produce a continuous vacuum for amniotic fluid aspiration as an alternative to using manually operated syringes.