Conception after contraception. How and when to plan a pregnancy after stopping birth control pills? Video “Gynecologist’s opinion on oral contraceptives”

Amniocentesis is the collection of amniotic fluid (amniotic fluid) during pregnancy for analysis. Amniocentesis is most often performed to detect chromosomal diseases in the fetus, but can be used to determine the level of maturation of the child’s lungs or diagnose intrauterine infections.

Amniocentesis is an invasive examination, that is, associated with the penetration of instruments into a woman’s body. Such diagnostics have risks and should be carried out only according to strict indications.

The essence of amniocentesis.

Before the procedure, the woman undergoes an ultrasound to determine the position of the baby. Then, under ultrasound control, the anterior abdominal wall, uterus and amniotic sac and collect a small amount of amniotic fluid.

Amniotic fluid contains fetal cells that can be used for genetic analysis(study of the set of human chromosomes). This examination detects neural tube defects, Down syndrome, trisomies 18 and 13 with 99% accuracy.

Amniocentesis is an unpleasant, but practically painless examination; it feels like a regular injection. However, some women may experience cramps and pain, mainly those who are too afraid or worried.

The procedure takes an average of 5 minutes, but then the woman is under observation for another 2 hours. After amniocentesis, a pregnant woman is recommended to limit physical activity and sex life for some time.

Should I do amniocentesis?

— the parents of the unborn child are close relatives;

— children with chromosomal diseases were previously born in the family;

- one of the parents is a carrier of a genetic disease;

— the woman had several miscarriages, the cause of which could not be determined.

If you are over 35 years old, then there is no point in putting your child at risk; first you can carry out perinatal screening(blood tests for biochemical markers and ultrasound) and in case of high or medium risk, already decide on amniocentesis.
However, think in advance about what you will do with the information received after amniocentesis. If the topic of artificial termination of pregnancy is closed to you, then doing such an examination is pointless. Some couples refuse invasive diagnostics because they have been waiting for a baby for a long time and are not ready to risk this pregnancy. Other parents are so afraid of deviations that they are ready to do anything to make sure that the child is healthy.

However, I would like to note that amniocentesis does not guarantee an absolutely healthy child. It excludes Down syndrome, some other chromosomal abnormalities, and a neural tube defect, but does not provide information regarding spontaneous developmental defects and genetic diseases associated with a mutation of a certain gene.

For example, mutations of some genes cause such hereditary diseases, such as hemophilia (blood clotting disorder, sickle cell anemia (disorder of the structure of hemoglobin). Standard analysis of amniotic fluid does not detect such diseases; diagnosis of individual hereditary pathologies is usually done when there have been such diseases in the family and for an additional fee.

Amniocentesis timing.

To diagnose chromosomal diseases, amniocentesis is usually performed at 15–16 weeks. There is also early amniocentesis at 10–12 weeks, but it is associated with a higher risk of miscarriage. In addition, at this stage, amniotic fluid may not be enough for analysis, so examinations up to 14 weeks are carried out only in very high risk chromosomal abnormalities.

The results of amniocentesis have to wait from one to three weeks- this is also a big drawback, because if it turns out that the child has a pathology, then the pregnancy will have to be terminated at a fairly long time.

For more later During pregnancy, amniocentesis can be used to determine the baby's readiness for birth (level of lung maturation) or to detect intrauterine infections.

Amniocentesis risks.

Unfortunately, amniocentesis is not completely safe procedure like blood tests or ultrasound examination. The risk of pregnancy loss after this manipulation is 0.5–1%. The shorter the pregnancy, the greater the risk of miscarriage. Also, the likelihood of pregnancy loss depends on the qualifications and experience of the doctor.

However, a miscarriage is not the only problem. During the procedure, there is a possibility of injury to the fetus. Also, amniocentesis can lead to infection of the fetus, leakage of amniotic fluid, and bleeding. After the procedure, a woman may experience nausea, vomiting, fever, and abdominal pain.

Very rare, but there are cases of removal of the uterus or death of a woman as a result of complications from amniocentesis.

Currently, obstetrics has much more opportunities to identify developmental defects and genetic abnormalities than it was 20-30 years ago. However, in the absence of ultrasound, genetic tests, invasive procedures, women carried their pregnancies more calmly.

And today, expectant mothers face a difficult choice: either rely on Mother Nature, or do prenatal screenings, the reliability of which is low, or take risks and agree to invasive diagnostics. It remains to be hoped that in the near future scientists and researchers will find more safe ways diagnosis of genetic diseases of the fetus.

Among all invasive prenatal tests, amniocentesis has the most high accuracy from 98 to 99%. The test helps determine the health of the fetus and detect any potential problems.

What is amniocentesis

Amniocentesis is a prenatal diagnostic test to check the amniotic fluid that surrounds the fetus in the uterus. This fluid contains cells and substances that indicate the baby's health.

To obtain amniotic fluid, the doctor inserts a long, thin needle into the uterus and withdraws a small amount of water, this fluid is sent for testing for specific genetic disorders (Down syndrome, spina bifida, cystic fibrosis).

The test results help detect problems in the development of the fetus, the test is carried out in certain time during pregnancy.

Amniocentesis is usually performed between 14 and 20 weeks, in the second trimester. Some doctors may recommend a test at 11 weeks. In some cases, amniocentesis is performed even in the third trimester.

This test has many uses, in addition to assessing the health of the unborn child, amniocentesis is prescribed if:

The results of prenatal screening revealed abnormalities
You gave birth to a child with a birth defect or any abnormality
You are 35 years of age or older to rule out the possibility of chromosomal abnormalities such as Down syndrome
You or your partner are carriers of genetic diseases such as cystic fibrosis
Your doctor suspects infection or anemia in the fetus
Your membranes are rupturing prematurely
Too much amniotic fluid is detected, an abnormality known as polyhydramnios

Process

How to do amniocentesis video

Amniocentesis is an outpatient procedure, meaning you do not need to stay in the hospital.

First, the doctor performs an ultrasound of the abdomen to check the exact location of the uterus.
A special gel is used to capture the baby's image on a monitor, along with a small device known as an ultrasound transducer.
After the ultrasound, the doctor injects painkillers into the abdominal area.
The ultrasound results give an idea of where to insert the needle.
The doctor then inserts a needle into the uterus through the abdomen, removing a sample of amniotic fluid.
The amount withdrawn depends on the week of pregnancy. You may feel a burning sensation as the needle enters the skin, and slight cramping as the needle penetrates the uterus.
The doctor continues to use ultrasound for monitoring heart rate child.

Pain and cramps in the first time after testing should not bother you; follow your doctor’s recommendations.

The doctor will give you detailed instructions about what to do after amniocentesis.

Within 3 days after the study, it is advisable to refuse:

Physical exercise
Prolonged exposure to air
Sex

Contact your doctor if you experience following signs infections after the procedure:

Fever
Severe uterine cramps that last more than a few hours
Vaginal discharge or bleeding
Unusual or poor fetal movement
Inflammation or redness in the puncture area

Amniocentesis test results

It will take from 3 days to 4 weeks to get results. Your doctor or genetic counselor will explain the results to you.

The amniotic fluid should be transparent in color with a light yellow tint. The liquid must not contain harmful bacteria.

Fetal cells are carefully examined and tested for chromosomal number and location, which show genetic disorders. There should be 46 chromosomes and 23 pairs. Any defect in them will lead to genetic abnormalities.

In the case of genetic amniocentesis, the test results will help diagnose or rule out various genetic disorders, neural tube defects and chromosomal abnormalities. The likelihood of problems being identified is high but it does not measure the severity of birth defects.

Abnormal results in any of the above cases mean your baby has a chromosomal abnormality or genetic disorder. However, several things can affect the test results.

What affects the results of amniocentesis?

Amniocentesis results may be incorrect for several reasons, such as:

Fetal blood in the amniotic fluid increases the content of alpha-fetoprotein and acetylcholinesterase in the substance, which test for neural tube defects.
Amniotic fluid exposed to light may show more low level bilirubin than it actually is.
Blood or meconium in the amniotic fluid leads to a false result at the level of maturity of the baby's lungs.

What to do if problems are found?

In such cases you pass genetic consultation, which provides you with more information. Based on this information, some women choose to continue the pregnancy, while others decide to terminate it.

Risks of amniocentesis

This is a difficult decision for any woman; you need to weigh the pros and cons of the procedure before you commit to it. As you already know the benefits of this procedure, let's look at the risks associated with the procedure:

Leakage of amniotic fluid: Amniocentesis sometimes causes amniotic fluid to leak from the vagina. Usually, the loss is minimal.
Miscarriage: Based on available statistics, the risk of miscarriage after the procedure in the second trimester is about 0.6%. On the other hand, the likelihood of miscarriage increases if the procedure is performed before 15 weeks of pregnancy. Most miscarriages occur within 72 hours after the procedure.
Needle injury to the fetus: If the baby moves during the test while the needle is inserted, there is a risk of injury to part of the fetus's body from the needle. However, serious needlestick injuries are rare.
Uterine infections: Although rare, there is a risk of infection of the uterus when bacteria manage to penetrate the amnion. This will cause high fever, cramps and abdominal pain. Uterine infection requires immediate medical intervention . However, the risk of infection is less than 1 in 1,000.
Transmission of infection: Amniocentesis carries a risk of transmission severe infections to your child. If you have HIV/AIDS, hepatitis C, or toxoplasmosis, your baby may be more likely to become infected during the procedure.
Clubfoot: Research suggests that performing this procedure on early stages, is associated with higher odds of clubfoot. Clubfoot is congenital deformity feet and ankle joint. Since there is increased risk development of this birth defect, most doctors will not perform amniocentesis until 15 weeks of pregnancy.

Amniocentesis is a procedure in which a puncture is made in the clear and smooth amniotic membrane to obtain a sample of the amniotic fluid (amniotic fluid) that surrounds the baby in the womb. This fluid contains cells developing fetus. Amniocentesis is performed for laboratory tests, amnioreduction, or administration medicines into the amniotic cavity.

This procedure can be performed in the first, second and third trimesters of pregnancy. Early amniocentesis is performed in the first trimester of pregnancy, before the 15th week, and late amniocentesis is performed after the 15th week of pregnancy, when the chorion and amniotic membrane fuse.

Amniocentesis is most often used to detect genetic abnormalities and can help diagnose or rule out many possible birth defects. The results may also reveal the baby's sex, assess lung maturity (if done close to your due date), detect infections in the amniotic fluid, or other pregnancy complications.

It is most often used to identify common genetic defects(for example, Down syndrome (trisomy on the 21st chromosome is one of the forms of genomic pathology, in which the karyotype is most often represented by 47 chromosomes instead of the required 46, causes mental retardation, birth defects hearts and physical characteristics- for example, such as skin folds around the eyes), which it detects or excludes, and neural tube defects (eg, spina bifida and hydrocephalus - hydrocephalus, excess congestion cerebrospinal fluid in the ventricular system of the brain). Children born with spina bifida have a bone that does not close properly. Serious complications spina bifida may also include paralysis of the legs, diseases bladder and kidneys, mental retardation.

If the pregnancy is complicated by a condition such as RH incompatibility (incompatibility between the Rh factor of the mother or father and their baby), the doctor may use amniocentesis to find out whether the baby's lungs are sufficiently developed.

Sometimes a chorionic villus sampling (CVS, or chorionic villus sampling) is used to detect many genetic abnormalities - a procedure that uses ultrasound to check the baby for diseases. It is done during the first trimester of pregnancy, between 11 and 14 weeks. During the test, a small sample is taken for analysis chorionic villi, that is, tiny finger-like growths in the placenta Because usually the genetic material in the villi is the same as that in the placenta. developing child, villi can be used for genetic studies), However, chorionic villus sampling does not detect neural tube defects. Instead of fetal cells, she tests placental cells, which are genetically identical to fetal cells. Because CVS can be done early in pregnancy and because results are available within 48 hours, it may be preferable for women who want quick answers about the quality of their baby's health. CVS, unlike amniocentesis, is associated with an increased risk of miscarriage and may increase the risk of limb deformities.

What are the risks of amniocentesis?

One in every 200 to 400 women will have a miscarriage as a result of amniocentesis, although recent studies suggest the miscarriage rate may be as high as 1 in 1,000 (0.1%). Amniocentesis done during the first trimester carries a greater risk of miscarriage than amniocentesis done after the 15th week. One in every 1,000 women will develop a uterine infection after amniocentesis.

How to prepare for amniocentesis?

Amniocentesis is used strictly to diagnose problems during pregnancy, but is not a treatment or cure for these problems. Therefore, a pregnant woman, before she undergoes this test, should think about how to properly use the information obtained as a result of it. Some birth defects are incompatible with life, others are easily corrected, and others fall somewhere in between. Women have many questions on this topic. Should a woman allow her pregnancy to be terminated if the baby has a very serious developmental defect? Will she know the results (which could take up to two or three weeks) early enough to consider terminating the pregnancy? A woman must weigh all the benefits and risks.

If a woman does not, under any circumstances, terminate her pregnancy, then not taking a test may cause, for example, more anxiety than necessary. On the other hand, if a woman knows in a timely manner that the child has serious problems health-wise, amniocentesis may allow her to be much better prepared for childbirth. One study of mothers who continued their pregnancies found that mothers who learned that their children had Down syndrome coped much better than women who only discovered at birth that their child was seriously ill.

If a woman decides to have amniocentesis, her doctor should give her detailed instructions on how to prepare for the procedure.

How is the amniocentesis procedure performed?

Amniocentesis is done in a special room, with or without local anesthesia. If local anesthesia is used, the woman may feel a burning sensation for a few seconds. She may also feel slight pain or cramping when the doctor inserts the needle and pressure in her lower abdomen when amniotic fluid is withdrawn. Some women report no pain or discomfort, but most doctors recommend several hours of rest after the procedure.

The procedure usually takes only a few minutes, during which the woman must lie still. The doctor finds the fetus using ultrasound. First of all, ultrasound is done to precise definition position of the fetus and placenta. This allows the doctor to determine the most safe place where to insert the needle. Using ultrasound guidance, the doctor carefully inserts a hollow needle through the abdomen into the amniotic cavity and draws out approximately four teaspoons of amniotic fluid containing fetal cells, which the technician will test in the laboratory. The child quickly fills up any amount of fluid that is lost. When the procedure is done, an ultrasound is done again to ensure that the fetal heartbeat remains normal.

At the time of amniocentesis, the woman should receive a non-sensitised RH immunoglobulin emulsion if she is an Rh-negative patient.

Doctors recommend that the woman in labor rest; after amniocentesis, she should avoid physical activity (for example, lifting heavy objects). If a woman experiences complications after the procedure, including cramping abdominal pain (pain that is inconsistent, comes on suddenly and often stops suddenly, changes location or severity), fluid leakage, vaginal bleeding or signs of infection, she should consult a doctor immediately.

After amniocentesis, there is a 0.25%-0.50% risk of miscarriage and a very small risk of uterine infection (less than 0.001%). In trained women and under ultrasound guidance, there may be fewer miscarriages.

Once the fetal cells (stem cells from the placenta) are removed, they are grown in the laboratory and then analyzed. In 95% of cases no abnormalities are found. The doctor should inform the mother of the results and, if a problem is diagnosed, provide the woman with information about how best to care for the baby after birth.
The technician will also measure the level of alpha-fetoprotein in the amniotic fluid. If it is high, the child may have a neural tube defect. If low, Down syndrome may be the cause. Because AFP does not need to be grown in a laboratory, these results are available immediately, although potential problem must be confirmed by subsequent genetic analysis.

When is amniocentesis prescribed?

Amniocentesis is not a mandatory diagnostic procedure during pregnancy. The test is usually only offered to women who are at increased risk of having a baby with birth defects. Including women giving birth:

Who are 35 years old or older;
- who have had a screening test (for example, high or low alpha-fetoprotein) or a test result that indicates a possible birth defect or other problem;
- who had birth defects during previous pregnancies;
- who have a family history of genetic disorders.

If the baby is truly sick, amniocentesis will detect this with 99% accuracy.

Doctors also offer amniocentesis to women with pregnancy complications, such as RH incompatibility, that require early testing.

If there are birth defects in the mother's family, then she needs to undergo genetic counseling before she undergoes an amniocentesis - and, if possible, before she becomes pregnant.

A woman and her partner may have certain blood tests to determine their chances of having a baby with birth defects.

Amniocentesis allows us to identify diseases and fetal development abnormalities such as:

Down syndrome;
- Patau syndrome;
- Edwards syndrome;
- spina bifida or spina bifida;
- sickle cell anemia;
- anencephaly;
- erythroblastosis;
- cystic fibrosis;
- degree of maturation of the unborn child’s lungs;
- herpes or rubella;
- Rh factor and gender of the child.

However, birth defects such as cleft palate and cleft lip, amniocentesis does not show.

Frequently Asked Questions

If amniocentesis showed normal results, does this mean I will have a healthy baby?

Positive result amniocentesis shows that the baby's genetic map is normal. But even with a normal chromosome pattern, a child may have other types birth defects. Approximately three out of every hundred children have some kind of birth defect.

Can doctors treat detected defects after amniocentesis?

Scientists are working on all sorts of methods and drugs to treat various fetal abnormalities. Many conditions can be treated after birth, and some can be corrected while the baby is still in the womb, although this type of surgery is still in the experimental stage.

Knowing about a child's condition ahead of time allows parents and doctors to prepare for the child's special needs, even if the child's condition is not clearly addressed. Knowing that the fetus has a genetic problem, such as Down syndrome, gives the woman the opportunity to take action and prepare for it.

I have a relative with Down syndrome. Should I undergo amniocentesis?

Down syndrome occurs when cells from a fertilized egg divide abnormally, creating an extra 21st chromosome. It is not family history but the mother's age that is most likely the most important factor risk. For example, a 20-year-old mother has a 1/2000 chance of having a child with Down syndrome. For a 45-year-old, the risk increases to 1/40. Very rarely, Down syndrome is inherited when the father or mother has an egg or sperm with a defective chromosome 21.

If a woman thinks her baby is at increased risk of developing Down syndrome, she should discuss the pros and cons of genetic testing with her doctor.

Is there an alternative to amniocentesis?

Eat a whole series screening tests that can help assess the risk of having a baby with a chromosomal problem. These tests are usually offered to women of all ages and include an ultrasound in the first trimester to measure the thickness of the baby's neck (nuchal translucency), along with maternal serum levels of PAP-A (pregnancy protein A) and other maternal serum, which must contain the four required chemicals. Then a second ultrasound is performed.

These tests are non-invasive (no surgical intervention inside the body) do not pose a risk of miscarriage or other problems, and can help accurately identify 65-90% of chromosomal problems. However, none of these tests can confirm 100% that a child has a problem. To make a diagnosis for sure, doctors must collect the baby's cells through amniocentesis or CVS.

The main disadvantage of amniocentesis is the time it takes to perform it. The test is usually carried out between the 16th and 18th weeks of pregnancy. If a woman decides to terminate the pregnancy, it is quite difficult to perform the operation during this period.

Surveys aimed at identifying various pathologies in the fetus, are carried out in the most different periods carrying a baby. One of them is amniocentesis.

What is it?

This study appeared in medical practice quite recently. For many centuries, doctors were not able to identify various pathologies intrauterine development fruit at the most early stages its development. Modern techniques allow doctors to do this quite successfully and efficiently.

Doctors call amniocentesis invasive technique. It consists in the puncture of the amniotic membrane. This is done with a special medical instrument, which is previously subjected to serious processing and is sterile.

During the examination A small amount of amniotic fluid is removed. The study of this biomaterial is carried out in the laboratory. Doctors may also inject medications into the amniotic sac during this procedure.

You can conduct research different methods. For this, doctors can use a special puncture adapter or use the technique "hands free".

Both of these methods make it possible to detect chromosomal pathologies in children quite effectively.

When is it held?

Doctors note that to carry out this procedure possible at the most different terms pregnancy. It is optimal if such a study is carried out at 17-20 weeks of fetal development.

If the examination is performed during the first trimester of pregnancy, it is called early. Doctors perform late amniocentesis after the fifteenth week of the baby’s intrauterine development.

Indications

The main purpose of this procedure is diagnostic. Amniocentesis shows already in the early stages of the baby’s intrauterine development the presence of various genetic pathologies. Such intranatal diagnosis is indicated for all pregnant women with a family history or predisposing risk factors.

If, after undergoing genetic screening, you expectant mother If possible signs of chromosomal diseases have been identified, doctors will also recommend that she undergo amniocentesis. This study can also be ordered by geneticist after consultation. If during screening a woman has laboratory tests and ultrasound revealed signs of genetic pathologies in the fetus, then amniocentesis is highly indicated for her.

This procedure can also be performed if the mother and her baby have a Rhesus conflict. In this clinical situation, the risk of developing various pathologies increases markedly. By examining amniotic fluid, these diseases are easily identified. Such a study is usually prescribed during complicated pregnancy.

During the 2nd and 3rd trimesters, doctors may resort to prescribing this procedure to establish the severity of functional disorders vital at work important organs fetus

Using amniocentesis, you can obtain information about the maturity of the lungs and the presence of surfactant in them, and assess the severity of hemolytic disease or diagnose various infectious diseases.

Amniocentesis can also be not only diagnostic, but also medical procedure. In this case, it is prescribed to women who have signs of polyhydramnios. During the procedure, the doctor can use a special instrument to remove excess amniotic fluid. If this procedure is performed correctly, risk of development undesirable consequences for the fetus is practically absent.

Some women develop pathologies in the second half of pregnancy that may require insertion into the amniotic sac. medicines. Doctors call this technique intraamnial. This procedure is carried out only experienced specialists with quite extensive clinical experience.

Fetosurgery is one of the the latest methods treatment of the fetus. In this case, doctors can eliminate certain pathologies and gross malformations even during intrauterine development. It is immediately worth noting that this method is quite new and is currently being improved.

Preliminary preparation

Before the study, the expectant mother will need to pass several laboratory tests. They are necessary so that doctors can identify possible contraindications for carrying out this survey. Such tests include general analysis blood and urine, as well as biochemical research (if indicated).

Also, the gynecologist usually makes a smear from the vagina to check for the presence of various infections. Exacerbation of infectious diseases may become a relative contraindication for amniocentesis.

Before carrying out this diagnostic procedure, the doctor usually prescribes the expectant mother to undergo an ultrasound. It is necessary to identify pathologies, as well as to assess the condition of the fetus before the procedure. Some specialists do not conduct a preliminary ultrasound examination, but perform it before the actual amniocentesis.

In order not to provoke bleeding during this procedure, doctors recommend that women Do not use any antiplatelet agents or anticoagulants for a week before the examination.

These medications thin the blood, which can lead to heavy bleeding during or after a diagnostic examination.

If the study is carried out after 21 weeks of pregnancy, the doctor will recommend that the expectant mother come for the study with a filled bladder. If diagnostic procedure is performed at earlier dates, then this is not necessary.

Before performing this invasive examination, the doctor must warn the expectant mother about all sorts of complications and consequences. this test. After such a conversation with the doctor, she signs voluntary informed consent . This medical document must be attached to the medical card.

How is it done?

The technique for carrying out this procedure is quite complicated. To carry it out, a special ultrasonic device is used. Using the sensor, the doctor finds best place for collecting amniotic fluid. The best localization is a place that does not come into contact with the umbilical cord loops.

The medical instrument will be inserted transplacentally. To do this, doctors try to determine the thinnest area where the thickness of the placenta is minimal. During the procedure, special puncture needles are used. During the research process, the doctor must monitor his actions. He sees the result on a special screen - a monitor.

To carry out the procedure, as a rule, no additional pain relief is required. In some cases, the doctor may use local anesthesia to reduce the pain component. For this, a 0.5% solution of novocaine is used. Before inserting a needle into the abdomen, the doctor will necessarily clean the abdomen. expectant mother alcohol disinfectant solution. This disinfection will help reduce the potential risk of infection.

After the needle has reached the place required for puncture, the doctor attaches the syringe and carries out the sampling. required quantity amniotic fluid. Usually the first 0.6 ml of the resulting biomaterial is poured out. According to doctors, he is unsuitable for research.

The first volume of amniotic fluid may contain many maternal cells. They may lead to the results of the study being unreliable. To carry out laboratory diagnostics 18-20 ml of amniotic fluid is required.

After the entire procedure, the needle is pulled out. The puncture site is treated with special disinfectant solutions.

After the entire procedure, the doctor must evaluate the condition of the fetus. To do this, he counts his heartbeat. If this study is carried out in the final period of pregnancy, then doctors will monitor the baby’s condition for some more time. In some cases, subsequent antibacterial prophylaxis may be indicated according to certain medical indications.

Within a couple of days after the procedure, a woman may experience a feeling of soreness in the lower abdomen. To reduce pain symptom Doctors prescribe painkillers and symptomatic remedies. Quite often, the pain disappears on its own, without the use of any medications.

On the first day after amniocentesis, gynecologists recommend staying in bed more.. Physical activity are excluded. You should eat light food, which is easily digestible and does not cause gas formation.

If after a few days the intensity pain syndrome in the abdomen does not decrease, and the woman develops spotting spotting from the genital tract or the body temperature rises, then in this case she should immediately consult a doctor. It is possible that she developed complications after the study.

What can be diagnosed?

This study allows us to identify hereditary and genetic diseases in the fetus. This examination is prescribed to all expectant mothers who have a family history of the development of such pathologies.

Using cytogenetic and molecular analysis of amniocytes, it is possible to effectively carry out prenatal diagnosis of many congenital diseases genetic apparatus.

Chorionic villus sampling can provide more accurate results studies to detect certain chromosomal pathologies. It is quite precise and extremely invasive.

What do the research results look like?

Experts note that the accuracy of the survey is 98.5-99%. More accurate results are recorded if the examination technique has not been violated.

In order to conduct research, the resulting biomaterial is inoculated onto nutrient media. It helps active growth fruit cells. After this, a cytogenetic examination is performed.

Poor test results may be reported with fetal ventriculomegaly.

Normal in genetic material there must be 23 pairs of chromosomes. If results are poor, this amount may change. This is how many genetic defects manifest themselves. Changes in the number of chromosomes occur in Down's disease, as well as in Patau and Edwards syndromes.

Also a poor result of amniocentesis may indicate that the baby has severe intrauterine developmental defects– anencephaly or spina bifida. After the study, specialists can exclude such dangerous conditions, like cystic fibrosis and sickle cell anemia. Both of these pathologies are extremely dangerous for later life fetus and can lead to the formation of various anomalies in the development of internal organs.

Laboratory analysis of amniotic fluid makes it possible to determine the presence of various dangerous pathologies, such as herpes and rubella infections. These diseases can lead to the formation of various congenital anomalies development.

In some cases, the results of the examination can determine the presence of various hereditary diseases linked to the sex X and Y chromosomes in the baby developing in the mother’s tummy. An example of such a disease is hemophilia. This disease manifests itself in boys and significantly impairs their quality of life.

When the results biochemical research amniotic fluid is ready, then the degree of maturity of the fetal lungs can be revealed. To do this, experts evaluate two indicators - lecithin and sphingomyelin. Their ratio is used to make a forecast.

If the resulting value is within 2/1, this indicates full maturity lung tissue baby. Indicator shift from 1.5 to 1.9/1 – possible sign developing distress syndrome.

If this criterion is equal to 1.5/1, then this is, as a rule, a consequence of distress syndrome.

Consequences and complications

All injection procedures are quite dangerous. Development risk adverse consequences after such manipulations it still exists. Doctors identify several clinical situations that can develop after complicated amniocentesis. These include:

untimely discharge of amniotic fluid;
release of amniotic fluid (especially on the first day after the procedure);
detachment of amniotic membranes;
the entry of various pathogenic microbes into the amniotic fluid and the development of infection;
traumatic damage to the blood vessels supplying the fetus;
injuries uterine arteries with the development of massive bleeding;
alloimmune cytopenia in a baby developing in the womb.

Contraindications for carrying out

Amniocentesis can only be performed for strict medical reasons. Any interference with the integrity of the amniotic membranes can lead to quite sad consequences both for the expectant mother and her baby.

For this procedure, doctors identify a number of contraindications. Thus, amniocentesis cannot be performed during acute period infectious disease. High body temperature and catarrhal symptoms– a relative contraindication for the study.

After the expectant mother recovers from a viral or bacterial infection This study can still be performed. Before undergoing it, a pregnant woman should be sure to visit a therapist so that he gives her an opinion on the possibility of carrying out this procedure after an infection.

The presence of large myomatous nodes or other neoplasms in the uterine cavity of the expectant mother is also a contraindication for this study. The risk of injury to such structures is very high. In this case, amniocentesis is usually not performed. An alternative to research in such a situation is laboratory tests and tests to identify various signs genetic and chromosomal pathologies.

The high risk of spontaneous abortion or miscarriage is also a contraindication for this examination during pregnancy. If for some reason a woman has already begun to have placental abruption, then this procedure cannot be performed either. In this case, the risk of intrauterine fetal death increases several times.

For more information about amniocentesis, watch the following video.

The fetus grows and develops in the womb for 9 months. All this time he seems to be floating in a bubble filled with amniotic fluid. This substance consists of various nutrients and elements that relieve the child of waste products.

For some pregnant women, doctors prescribe a procedure called amniocentesis – what is this, patients wonder. The very name of perinatal surgery scares expectant mothers.

In this article we will try to understand all the features of this procedure. To find out how dangerous amniocentesis is during pregnancy, you need to carefully study even its minor nuances.

Amniocentesis is a prenatal procedure in which a doctor punctures the amniotic sac to remove a sample of amniotic fluid. This fluid contains cells developing embryo. Thanks to this procedure, the doctor can conduct laboratory tests to identify pathologies of fetal development. Also, during amniocentesis, special medications can be injected into the amniotic cavity.

When is amniocentesis performed? The answer to this question worries many pregnant women, because they are afraid that such a procedure could harm the baby. There's no need to worry. Depending on the indications, amniotic fluid puncture can be performed in the 1st, 2nd or 3rd trimester.

Early (before the 15th week) and late (after the 15th week) amniocentesis have minor differences. The thing is that by the end of pregnancy the amniotic membrane and chorion are united.

Puncture of the amniotic membrane allows you to perform the following tasks:

Take a puncture of amniotic fluid for laboratory diagnostics;
Pump out excess amniotic fluid (amnioreduction);
Administer medication for emergency termination of late pregnancy;
Administer medications to support and develop the fetus.

The timing of amniocentesis is very important. Doctors recommend performing this procedure between the 16th and 20th weeks of pregnancy.

Types of procedure

Now you already know what amniocentesis is during pregnancy. Reviews about this procedure are different. For some, it helped solve certain problems with fetal development, but for others it became unnecessary stress. It is better to decide whether or not to do amniocentesis together with your doctor.

IN modern medicine There are several types of this procedure. Depending on the timing, amniocentesis can be:

Early (the procedure is carried out from the 8th to the 14th week inclusive);
Late (prescribed to patients whose pregnancy is more than 15 weeks).

The technique for puncturing the amniotic sac can also vary. Most often, a puncture adapter is used for this, which makes an accurate puncture, but does not injure adjacent tissues. The free-hand method is used less frequently. During this procedure, the physician independently controls the direction and depth of the puncture.

If you are recommended to undergo such a procedure, be sure to first read reviews about amniocentesis on women's forums, find out about the features and purposes of the operation. Amniocentesis is not a routine test. This procedure is only used in extreme cases when there is a suspicion of pathology of fetal development. The doctor is obliged to warn the expectant mother about this.

Indications

Indications for amniocentesis may vary. The decision on the need to perform such a procedure is made by the doctor only if the diagnostic method ultrasound examination does not give accurate results, and there is a suspicion of the development of pathologies in the fetus.

What pathologies does amniocentesis reveal? Such deviations may be associated with poor genetic inheritance or negative factors environment. These include:

Chromosomal abnormalities (can be congenital or hereditary, diagnosed in the 1st trimester);
Hemolytic disease, lung pathologies, intrauterine infections(detected later in pregnancy).

If you have been prescribed amniocentesis, do not rush to get upset and panic. The thing is that indications for such a procedure can be not only fetal pathologies. Amniotic fluid puncture is necessary for:

Excessive amount of amniotic fluid;
Necessities medication interruption late pregnancy;
To obtain anatomical fluid from embryonic tissues necessary for the treatment of serious diseases;
For fetosurgery.

If you have an indication for amniocentesis, agree to the procedure without any hesitation.

Many people are interested in the answer to the question “Can amniocentesis be wrong?” Professional doctors claim that this type of diagnosis allows you to get 100% reliable results. Amniocentesis can detect about 200 types of gene pathologies and abnormalities in the development of the embryo. Such diseases include Down syndrome, Edwards syndrome, etc.

Contraindications

Despite the fact that the consequences of amniocentesis can be quite dangerous, this procedure is performed quite often. It has a minimum of contraindications. Amniotic fluid puncture is not recommended in the following cases:

Seasonal inflammation or respiratory disease. Amniocentesis is not recommended for colds. We have to wait full recovery the expectant mother in order to obtain the most accurate diagnostic results.
Peeling children's place ahead of schedule.
Presence of genital infection.
Pathologies of the structure and development of the uterus.
Threat of premature birth or miscarriage.
Tumor neoplasms in the genital organs of large diameter.
Insufficient blood clotting.
Incorrect location of the placenta.

Every woman has every right write a refusal to undergo amniocentesis if she is afraid that such a procedure will harm her child. In this case, it is necessary to carefully weigh all the pros and cons and evaluate possible consequences making the wrong decision. You can choose amniocentesis or cordocentesis. This alternative has its pros and cons.

Procedure

Before the procedure, careful preparation for amniocentesis should be carried out. This will allow the patient to get rid of unnecessary fears and worries and will guarantee the most accurate diagnostic results. You can watch the amniocentesis video to see firsthand how it all happens.

The preparatory stage consists of several parts, namely:

First of all, the patient will have to undergo a full examination of the reproductive system - take tests, undergo an ultrasound. This will eliminate contraindications, determine the amount of amniotic fluid, and establish the exact timing of pregnancy.
7 days before the intended procedure, it is recommended to stop taking medications that contain acetylsalicylic acid.
Do not take anticoagulants the night before your amniocentesis.
Both spouses must fill out the appropriate documentation and agree to this procedure.

When preparatory stage completed, you need to contact the doctor who will perform the operation directly.

Amnitesis is carried out in an operating room or a sterile ward, where all hygienic conditions. The patient lies on the couch. The entire process of creating a puncture is carefully monitored using an ultrasound machine. The needle is carefully inserted into the abdomen, and amniotic fluid is pumped out (20 ml is enough). After completing the procedure, the doctor must check the baby's heartbeat in the womb to make sure everything was successful.

Rehabilitation

Now you know how amniocentesis is done. Special rehabilitation after such a procedure is not required. Doctors recommend that patients adhere to bed rest to fully restore your strength. You also need to completely avoid any physical activity for a while.

Pregnant women with negative Rh factor need complementary therapy. For 3 days, such patients are given injections of anti-Rhesus immunoglobulin. If necessary, the physician may prescribe analgesic or anti-inflammatory drugs.

Pregnant women are very afraid of amniocentesis because they think it painful procedure. Reviews about the sensations during a puncture are different. Some people feel no discomfort at all, while others feel minor discomfort. It can definitely be said that severe pain The doctor’s manipulations will not bring you any relief. Doctors do not recommend using additional anesthesia, since then you will have to perform two punctures at the same time.

Results

The amniocentesis procedure does not end at the stage of amniotic fluid removal. It is important to correctly study and decipher the results of such diagnostics. After careful laboratory tests, you can full confidence confirm or refute a previously made diagnosis. The accuracy of amniocentesis is 99.5%. This procedure is prescribed by doctors in the most doubtful cases in order to obtain the most accurate result.

After diagnosis, the patient is given a document depicting the chromosomes of the embryo. The diagnosis is indicated at the very bottom of the page. You need to know how to decipher such results in order to save yourself from unnecessary worries.

For a female child, the chromosome norm is 46XX;
For boys – 46XУ.

If you see such results, you don’t need to worry about your baby’s health. In children with genetic abnormalities There may be 47 chromosomes or vice versa 45. Such a baby will most likely be born with Down syndrome or another chromosomal pathology. You will have to wait about 2 weeks for your test results, so please be patient.

Consequences

Any invasive procedure, including amniocentesis, may have side effects. The placenta, in which a small hole is made, may react negatively to such intervention. The most common side effects from amniotic fluid puncture are:

Leakage of amniotic fluid ahead of schedule. This may lead to miscarriage or premature birth. Water may only leak slightly after the procedure. If this symptom disappears within 24 hours, there is no need to worry.
Detachment of the placenta membrane.
Fetal infection. The likelihood of such a complication is especially high if amniocetesis is performed in the 2nd trimester of pregnancy. The thing is that it is during this period that the liquid contains minimum quantity antibacterial substances.
Minor bleeding from the vagina. As a rule, they disappear on their own 1-2 days after the test.
Deficiency of certain blood cells in the fetus.

Despite the fact that complications after amniocentesis are more than serious, you should not stress yourself out in advance. Such side effects occur very rarely and are most often associated with non-compliance with certain rules during preparation for the procedure.

If, within a few days after the test, a pregnant woman feels nausea, discomfort in the lower abdomen, and pus begins to ooze at the puncture site, she should immediately consult a doctor.

To do or not

Many women, despite strong recommendations from doctors, do not agree to undergo amniocentesis, fearing the consequences or pain during the puncture. If you are also tormented by doubts, it is better to talk about this with your doctor. The opinions of women communicating on the forum should not be blindly trusted.

The doctor will honestly tell you how great the risk is to the health of the mother and child after such manipulations. It all depends on what diagnosis needs confirmation and what are the indications for amniocentesis. Not every parent is ready to raise a child with Down syndrome. Complications after a puncture are quite rare and are only an exception to the rule.

Such an analysis cannot show erroneous results. This study is considered one of the most reliable in modern medicine. It is mandatory to carry out this procedure if genetic disorders were detected in the fetus at any stage of pregnancy.