Abstract
Purpose: To evaluate the effect of clinical and demographic factors on the further course of pregnancy and post-procedure complications in healthy and high-risk pregnancies. Materials and Methods: Data of 230 amniocenteses with normal (n=174) and abnormal genetic findings (n=56) were collected retrospectively. Details of birth, neonatal condition, patient characteristics, and post-procedure complications were analysed. Results: The mean maternal age at amniocentesis was 34.50 ± 5 years-old. One hundred (43.48%) were followed by at least one complication. Fetal death occurred after 11 (4.78%) procedures including seven with genetic disorders. There was no significant difference in complication rates between study groups, except for fetal death, which was significantly more common in high-risk pregnancies (p = 0.0017). Abdominal pain correlated with pyrexia and vaginal bleeding. Conclusion: The most severe complications were associated with fetal genetic disorders. The authors conclude that amniocentesis is a safe procedure; however, significant correlations between the incidence of certain complications may be relevant in planning antenatal care.
Highlights
Proper antenatal care and prenatal testing lead to the reduction of ante- and perinatal mortality. [1, 2] According to the guidelines published by the Polish Society of Gynecology, all pregnant women should be offered screening for the most common developmental abnormalities and chromosomal aberrations
Amniocentesis had to be repeated in three women, while four other women had twin pregnancy
The mean age of women with normal pregnancy was 34.34 ± 4.23 years-old; amniocentesis was performed in this group at the mean gestational age of 16.18 ± 2.14 weeks
Summary
Detection of fetal developmental abnormalities or health conditions enables optimal preventive and therapeutic management. [1, 2] According to the guidelines published by the Polish Society of Gynecology, all pregnant women should be offered screening for the most common developmental abnormalities and chromosomal aberrations. Invasive tests can be offered to pregnant women over 40 years of age, as well as to those who did not consent to screening [3]. Nicolaides et al designate the period of 11 to 13 gestational weeks as the optimal window for prenatal screening, postulating that once the pregnancy is classified as low-risk, the number of follow-up tests can be significantly reduced [4]. The estimated incidence of major genetic anomalies leading to developmental disorders is about 2-3% of all live births [5-7]. The total incidence of genetic aberrations is difficult to estimate, since most such fetuses, especially those with major anomalies, die early in pregnancy, and the preimplantation loss rates are completely unknown. Chromosomal aberrations are found in approximately 50% of spontaneously miscarried embryos, or approximately 2% of fetuses spontaneously miscarried at 16-18 gestational weeks, compared to only one in 160 living births [8, 9]
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