TRANSPLACENTAL NEEDLE PASSAGE AND OTHER RISK-FACTORS ASSOCIATED WITH 2ND-TRIMESTER AMNIOCENTESIS

Objective. To assess the obstetric outcome of all pregnancies undergoi ng midtrimester amniocentesis over a 10 year period at one center and the risk-factors for pregnancy loss associated to the procedure. Mater ial and method. All 2083 pregnancies with known pregnancy outcome and second trimester amniocentesis were included. Risk-factors for pregnan cy loss were analysed by using patients' charts and a special record f rom the amniocentesis. Results. The over-all risk of pregnancy loss af ter second trimester amniocentesis was 1.3% (28/2083). There was a sli ght but nonsignificant relationship between the degree of experience o f the gynecologist and risk for pregnancy loss. A more experienced ope rator used significantly fewer needle insertions (p<0.001). Multiple n eedle insertions were also associated with a slight, albeit nonsignifi cant, increase in incidence in fetal loss (3.8% after three or more in sertions vs. 1.2% after one insertion, NS). No difference in spontaneo us abortion incidence was found in patients having an anterior versus a posterior placenta, nor did transplacental needle passage increase t he risk for pregnancy loss. Comparison between use of real-time ultras onic guidance at the amniocentesis and static ultrasonography immediat ely prior to the procedure did not reveal any differences in the incid ence in spontaneous abortion. Conclusion. Second trimester amniocentes is seems to be a safe method for prenatal diagnosis. The risk for preg nancy loss was low (1.3%) and was only slightly and nonsignificantly a ffected by the operator's experience and multiple needle insertions. T ransplacental needle passage did not affect the risk of pregnancy loss .