A comparative evaluation of the risks and complications of early amniocentesis

Objective: The purpose of this report is to present the complications and pregnancy outcome experience for early genetic amniocentesis. Study design: We compared amniocentesis-related complications and pregnancy outcome in singleton gestations of 370 women undergoing genetic amniocentesis at 11.0-13.9 weeks' gestation (Group I) with those of 395 women undergoing amniocentesis at 14.0-14.9 weeks' gestation (Group II). All procedures were performed with ultrasound guidance using a 22-gauge needle between June 1989 and March 1995. The primary indication for amniocentesis was advanced maternal age or prior aneuploidy. Complications evaluated included maternal cramping, bleeding, amniotic fluid leakage and fetal loss before 20 weeks. Analysis was by χ2 with significance at the 0.05 level. Results: Early Group I procedures included 58 at 11 weeks, 114 at 12 weeks and 198 at 13 weeks' gestation. Leakage of fluid within 24 to 48 h occurred in 25 (6.8%) for Group I and 18 (4.6%) for Group II procedures (p = NS). Procedure-related fetal losses (spontaneous abortion or fetal demise before 20 weeks) occurred in 11 (2.7%) in Group I versus seven (2.0%) for Group II (p = NS). Fetal loss within 2 weeks of amniocentesis occurred in four (1.1%) for Group I and two (0.5%) for Group II procedures. Of women with leakage of fluid, two of 24 (8.0%) in Group I and one of 18 (5.5%) in Group II experienced losses. Twenty-six women in both groups experienced cramping. No women with cramping alone experienced a loss. The rate of maternal bleeding, preterm delivery and aneuploidy was similar for both groups. Conclusions: The rates of fetal loss and maternal complications are similar for early amniocentesis performed at 11-13.9 weeks and those performed at 14 weeks' gestation.

Duke Scholars

Author Haywood Laverne Brown Obstetrics and Gynecology, Maternal Fetal Medicine