Amniocentesis early assessment in an institution of prenatal diagnosis in Brazil

Evaluación de la amniocentesis precoz en una institución brasileña de diagnóstico prenatal

Although mid-trimester amniocentesis (MA) is a safety and reliability procedure, cytogenetic diagnosis report is only informed in an advanced period of pregnancy. First trimester amniocentesis  (12-14 weeks) shows some advantages on MA and others of chorionic villus sampling (CVS), but its safety requires careful analysis. The aim of this study was to evaluate the fetal loss and congenital anomalies in a population of 479 pregnant women (single gestations) who underwent first trimester amniocentesis (12-14+6/7 weeks). Under ultrasound-guided procedures approximately 1ml of amniotic fluid per gestational week was collected. Mean maternal age was 35.7± 1 4.58. The main indication for the test was maternal age 35 or greater (66.1%). Follow up was successful in 90.2% (432/479) patients. Amniotic fluid was successfully aspirated in the first attempt in 406 cases (94%). Fetal loss rate was 4.9%, 2.9% were observed before 28 weeks. Differences in fetal loss rates associated to different categories of maternal age were not statistically significant. The distribution of fetal losses by different categories of gestational age showed no significant differences. No association between fetal loss and collected volume of amniotic fluid was observed. 5.1% and 2.3% of patients reported amniotic fluid loss and bleeding, respectively. Such complications were significantly associated with fetal loss. Eight cases (2%) of respiratory problems and two (0.5%) of musculo-skeletal anomalies were observed. Our data suggest increased complications and fetal losses at earlier gestational ages, especially at less than 13 weeks. Amniocentesis at 14 weeks poses low risk of fetal loss or congenital anomalies and may be routinely offered to patients, provided that operators are experienced, technical measures taken, and collected volume of amniotic fluid is minimized.

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59. DOI: http://dx.doi.org/10.22490/24629448.513