Amniocentesis in a tertiary referral centre: still the same old story?

Abstract

Overview and Aims: The main objective of this study was to describe the main clinical indications, diagnostic yield, complications and pregnancy outcomes regarding amniocentesis performed in a tertiary University Hospital, during an 8-year period. Study Design: We developed an observational, retrospective study, of all amniocenteses performed between June 2003 and June 2011. Population: All pregnant women consecutively submitted to amniocentesis in a tertiary University Hospital between June 2003 and June 2011. Only singleton gestations were included. Methods: We searched the database of the Genetics Department for all products obtained by invasive procedures performed during pregnancy between June 2003 and June 2011, in order to identify the amniocenteses performed during that period. Maternal demographics, indication for amniocentesis, gestational age at the time of amniocentesis, procedure-related complications during pregnancy and pregnancy outcome data were extracted from patient's physical and electronic medical records. Results: A total of 1358 amniocenteses were included in the study. The proportion of amniocentesis performed due to maternal age decreased significantly and due to positive prenatal screening significantly increased over time (p<0,001).The indication with highest positive predictive value regarding abnormal fetal karyotype was parent carrier of chromosome abnormality (46.2%). Total pregnancy loss was 1.6%, post-procedural miscarriage rate was 0.74% and fetal loss risk within 2-weeks of procedure was 0.4%. There was no association between fetal loss and operator, number of needle insertions, transplacental puncture and bloody tap. Conclusions: Counselling is complex and questions regarding procedure-related complications and fetal loss have been inconsistently reported. National and local institutional precise estimates are important to consider when advising women requesting amniocentesis.