Amniocentesis

What is an amniocentesis?

An amniocentesis is a procedure used to obtain a small sample of the amniotic fluid that surrounds the fetus to diagnose chromosomal disorders and open neural tube defects (ONTDs) such as spina bifida. Testing is available for other genetic defects and disorders depending on the family history and availability of laboratory testing at the time of the procedure. An amniocentesis is generally offered to women between the 15th and 20th weeks of pregnancy who are at increased risk for having a baby with a chromosome abnormality, neural tube defect, or some other genetic condition.

How is an amniocentesis performed?

An amniocentesis is a procedure that involves inserting a thin needle through the mother's abdomen into the amniotic sac to withdraw a small sample of the amniotic fluid for examination. The amniotic fluid contains cells shed by the fetus, which contain genetic information. Although specific details of each procedure vary slightly, generally, an amniocentesis follows this process:

The woman's abdomen is cleansed with an antiseptic.
The insertion of the needle is like a blood draw and usually does not require local anesthetic.
Ultrasound is used to help guide a very thin needle into the amniotic sac.
A small sample of fluid is withdrawn for laboratory analysis.
Strenuous activities should be avoided for 48 hours following an amniocentesis.
Women may feel some cramping during or after the amniocentesis.

Women with twins or other multiples need sampling from each amniotic sac, in order to study each baby. Depending on the position of the baby, placenta, amount of fluid, or mother's anatomy, sometimes the amniocentesis cannot be performed.

The fluid is sent to a genetics laboratory so that the cells can grow and be analyzed. Alpha-fetoprotein, a protein made by the fetus that is present in the fluid, is also measured to rule out an open neural tube defect, such as spina bifida. Results are usually available in about two weeks.

What are the risks and benefits of amniocentesis?

Risks	Benefits
After an amniocentesis, women may experience cramping, bleeding, or leaking of amniotic fluid. There is also a slight risk of infection. The risk of miscarriage is about one in 300 after an amniocentesis in the second trimester of pregnancy, in addition to the background risk. The American College of Obstetricians and Gynecologists (ACOG) does not recommend early amniocentesis (before 13 weeks) because the risks for miscarriage and pregnancy complications are higher than with amniocentesis performed between 15 and 20 weeks.	Amniocentesis helps confirm a tentative diagnosis of an abnormality found with other testing. It may also find that a fetus does not have the abnormality that was suspected. This allows couples to plan the remainder of pregnancy and to consider their options. Amniocentesis offers: diagnosis of a chromosomal abnormality. diagnosis of open neural tube defects (over 95 percent; closed or small defects may show a normal result). diagnosis of other defects depending on the family history and availability of testing.

Risks

Benefits

After an amniocentesis, women may experience cramping, bleeding, or leaking of amniotic fluid. There is also a slight risk of infection. The risk of miscarriage is about one in 300 after an amniocentesis in the second trimester of pregnancy, in addition to the background risk.

The American College of Obstetricians and Gynecologists (ACOG) does not recommend early amniocentesis (before 13 weeks) because the risks for miscarriage and pregnancy complications are higher than with amniocentesis performed between 15 and 20 weeks.

Amniocentesis helps confirm a tentative diagnosis of an abnormality found with other testing. It may also find that a fetus does not have the abnormality that was suspected. This allows couples to plan the remainder of pregnancy and to consider their options. Amniocentesis offers:

diagnosis of a chromosomal abnormality.
diagnosis of open neural tube defects (over 95 percent; closed or small defects may show a normal result).
diagnosis of other defects depending on the family history and availability of testing.

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