Amniocentesis, Here's What You Need to Know

Amniocentesis is a procedure performed during pregnancy to check a sample of amniotic water. This procedure is useful to determine the presence or absence of abnormalities in the fetus. If necessary, amniocentesis will be recommended to pregnant women when the gestational age reaches 15-20 weeks. In an amniocentesis procedure, the doctor uses a special needle to take a sample of amniotic fluid (amniotic water), by jabbing it into the mother's abdomen to the uterus. The doctor will check the fluid containing the cells to give clues about the condition of the fetus. The cells are examined based on the size and number of fetal chromosomes, which indicate if there is a risk or disorder that harms the fetus, one of which is to know Down's syndrome.

Indications Amniocentesis

Doctors recommend amniocentesis when the gestational age is 15-20 weeks. This is done with the aim of:

• Knowing fetal chromosome abnormalities before birth. Amniocentesis examination is carried out if after an ultrasound examination a pregnancy is suspected of abnormalities in the fetus.
• Knowing the development of the fetal lungs.
• Ensuring the occurrence of chorioamnionitis, namely bacterial infection of the amniotic sac (amnion) and the placenta-forming layer (chorion).
• Evaluating fetal abnormalities due to alloimmunization, which is an abnormality due to the response of the mother's immune system or immune system that was transferred to the fetus, and cause problems for the fetus. Abnormalities due to alloimmunization are abnormalities due to rhesus incompatibility (rhesus incompatibility) or fetal hydrops. If rhesus incompatibility is not detected early it can endanger the condition of the fetus.
• Polyhydramnios treatment, namely by giving drugs directly into the membranes, to reduce pressure in the uterus. Amniocentesis can also be used to give drugs directly to the fetus.

Fetal abnormalities are more prone to occur in pregnant women with the following conditions:

• Over 35 years old.
• Have a family history or a child born before with metabolic disorders or gene abnormalities, such as Down syndrome, Tay-Sachs disease, or cystic fibrosis.

Amniocentesis warning

Amniocentesis is a safe procedure. Even so, there are still some conditions that cause pregnant women need to be careful before performing amniocentesis. These conditions include:

• Lack of amniotic fluid (oligohydramnios).
• Deformity of the placenta.
• Have an allergy to drugs, latex, or adhesives.
• Are using other drugs, such as blood-thinning drugs.
• Have a history of blood clotting disorders.
• Difference between rhesus blood type and fetus contained.
• Suffering from hepatitis or HIV.

Before Amniocentesis

There is no special preparation before undergoing amniocentesis. Pregnant women also do not need to fast before action. In some cases, pregnant women are advised to hold back urination, because this procedure is easier to do if urine meets the urinary tract. Ask your husband or family to accompany and accompany you during the procedure.

Amniocentesis procedure

The doctor will ask you to lie comfortably in the examination room bed. The doctor will help you position yourself in the lithotomy position, which is lying on your back, knees and hips bent, and your legs will be supported. When you are lying down comfortably, your doctor will use ultrasound to check the condition of the fetus, fetal heart rate, location of the placenta, and the location of amniotic fluid. The doctor will use anesthetic that is injected around the stomach to reduce pain. However, anesthesia is not always used in amniocentesis because the effect is not felt so important. Ultrasound is also used as a guide to jab the needle into the abdominal wall until the tip of the needle is in the center of the amniotic sac. The doctor will take about 30 ml (about 2 tablespoons) of liquid. This procedure lasts briefly, which is about 30 seconds to several minutes. If taking a sufficient amount of fluid is felt, the doctor will carefully pull the needle out of the stomach. After that, the doctor will apply an antiseptic solution and cover the puncture area in the abdomen with a bandage.

After Amniocentesis

After amniocentesis, the doctor will check the fetal heart rate with a special instrument, ensuring that the fetus does not experience stress. If you have a rhesus negative blood type, and the fetus is suspected of having a rhesus positive blood type, your doctor will give you a Rho injection after the procedure. Rho injections aim to prevent alloimunization reactions to the fetus. Your doctor will allow you to go home and suggest resting at home, as well as avoiding activities with repetitive movements and sexual relations for 1-2 days. Amniotic water samples will be examined further in the laboratory and the results can be obtained in a few days to a month. Discuss with the doctor the results of amniocentesis that have been undertaken.

Complications of Amniocentesis

Consult your doctor if you experience complications after undergoing amniocentesis. Amniocentesis can cause a number of complications in the form of:

• Transmission of infection. Pregnant women who have infections, such as hepatitis or HIV, are at risk of infecting the fetus through amniocentesis.
• Amniotic water leak. Although rare, leakage of amniotic fluid can occur. If this happens, the condition of the mother and fetus will continue to be monitored by doctors, especially if there is an infection. In this case, the risk of complications of preterm birth will increase, which is generally caused by the least amount of amniotic fluid remaining.
• Research shows that the chance of amniocentesis to cause the risk of miscarriage is very small. Miscarriages due to amniocentesis are only 0.2-0.3 percent of all pregnancies.
• Injury to the fetus, such as lung disorders, dislocation of the hip, or clubfoot.