What is amniocentesis? What kind of process is it and how long does it take? Could you briefly explain?
The baby is in the amniotic fluid in the womb. Amniotic fluid is mostly the baby's urine and contains plenty of baby cells. Genetic analysis is performed with these cells and provides information about the baby's chromosomes.
Amniocentesis; It is the process of examining the fetus by taking a sample of the amniotic fluid in which it lives in the womb.
Amniocentesis process; It is performed in the outpatient clinic under the guidance of ultrasonography. After the mother's abdomen is prepared sterile against the risk of infection, 9-15 cm. It is performed by entering the mother's abdomen with a thin needle and taking a sample of 15-20 ml from the amniotic fluid in which the fetus lives. The processing time takes 3-5 minutes after the preparations are completed. The duration may sometimes be extended due to the fetus changing position.
There is no need for additional anesthesia because the duration of the amniocentesis process is short and the pain is low.
Most of the fluid taken from the mother's womb is the baby's urine and within 24 hours. The amniotic fluid in the womb returns to its previous state.
The fluid taken from the womb is sent to genetic laboratories. Here, long-term amniotic cell culture or short-term (FISH or PCR) tests are performed. For standard tests, results are generally obtained within 1-21 days. It may take months for some special tests to be finalized.
What are the risks of amniocentesis for expectant mothers and babies?
Most pregnancies with amniocentesis are problematic and risky pregnancies. It is not possible to clearly distinguish the source of risky pregnancies and negative outcomes. As classical information, after amniocentesis, the rate is approximately 0.5%
- Bleeding
- Breaking of water
- It may be complicated by the loss of the fetus.
Pregnancy continues in approximately half of the cases with water breaking or bleeding.
During the amniocentesis process, no direct harm is possible if there is no contact with the fetus. There is a risk of developing infection after the procedure, although it is very rare. Generally, this risky period covers 3-4 weeks after the procedure.
Who should have amniocentesis and in what situations? amniocentre What are the conditions that must be done? Which situations are left to the decision of the expectant mother?
Amniocentesis is performed after being informed by the perinatologist and obtaining the family's consent / or genetic counseling.
Situations in which amniocentesis is recommended;
- Due to the high risk of Chromosomal anomaly
- Increased nuchal translucency
- Nasal bone hypoplasia or absence
- Ventriculomegaly, i.e. accumulation of water in the baby's brain
- Cardiac anomalies
- Other major anomalies (Ompholocele, Diaphragmatic hernia, etc.)
- Non-Invasive Prenatal Test (NIPT) with fetal DNA from maternal blood ) high risk
- In cases of hereditary disease in the family
What is the opinion of amniocentesis in Turkey and the world? Can you compare?
Parents do not have much information about the amniocentesis process. Parents are not informed enough about this issue, and even doctors do not allocate enough time for this. Families who have little information about its content and results inevitably have prejudices about amniocentesis. The concerns of expectant mothers in Turkey and pregnant women around the world are actually the same. However, it is clearly seen that we are lacking in knowledge from expectant mothers around the world, especially when it comes to amniocentesis.
What approach should be taken to facilitate the decision-making of the expectant mother in cases where amniocentesis is necessary?
The expectant mother should be clearly explained what Amniocentesis is and for what purpose it will be performed. Many families react to amniocentesis with incomplete and incorrect prejudices such as "We do not want our child to do anything" or "We do not want to abort our child." It is very important to explain clearly that the amniocentesis test is performed to answer the question of whether the baby has a suspected disease. It is necessary to explain to the family how important the answer to this question is for pregnancy and the newborn. When necessary, amniocentesis is one of the most important steps in the entire pregnancy management and welcoming the newborn. The fact that this happened should be discussed with the families. After discussing all aspects of the amniocentesis process with the parents, it is much easier to achieve results with the families learning the details, goals and gains.
How can the spouse and close circle provide support after the amniocentesis decision?
Amniocentesis is ultimately a procedure performed in high-risk pregnancies. Any pros and cons about amniocentesis should be explained to the parents. It is necessary to direct the family, who decides on amniocentesis, to positive thinking by telling them that they may encounter all kinds of consequences.
What kind of test is the international blood test ("Non-Invasive Prenatal Test (NIPT) with fetal DNA from maternal blood)?" Who should we do it for?
Non-Invasive Prenatal Test (NIPT) is a very good screening test performed by taking blood from the mother. The result is reached by genetic analysis of free fetal DNA in the blood. The results of the test are high or low risk. It is categorized as a high-cost screening test.
NIPT screening test;
- Pregnant women aged 35 and over
- Pregnancies with a history of trisomy 21 and 18
- Pregnancies with a positive screening test
- It is recommended for pregnant women who have markers for Tr 21 and 18 on ultrasonography but do not accept invasive procedures.
Have amniocentesis practices decreased after the blood test sent abroad became available? Is there no need to take the risk of amniocentesis when having this test done? Are parents adequately informed on this issue?
The widespread use of Non-Invasive Prenatal Test (NIPT) provides convenience for both doctors and patients. The widespread use of this test has also reduced the application of amniocentesis.
However, Non-Invasive Prenatal Test (NIPT) with fetal DNA from maternal blood is a screening test and is not in the same category as amniocentesis. NIPT may have false positivity, that is, false results. High-risk group patients must be confirmed with amniocentesis or other invasive tests.
Again, it should be noted that requesting NIPT in every abnormal situation or using it incorrectly may cause a delay in diagnosis or incorrect evaluation. If NIPT is requested for a reason. First of all, these pregnancies are diagnosed by a perinatologist. should be evaluated carefully. This approach; In addition to the correct management of pregnancy, it also contributes to time and cost.
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