TRANSPLACENTAL NEEDLE PASSAGE IN EARLY AMNIOCENTESIS AND PREGNANCY LOSS

Objective: To determine whether transplacental needle passage affects the frequency of pregnancy loss in early amniocentesis. Methods: We re viewed 380 consecutive cases of amniocentesis performed before 14.9 we eks' gestation because of advanced maternal age (at least 35 years old ). Procedure and pregnancy outcome data were obtained from reviews of patients' charts and telephone contact with patients or referring phys icians. Results: Transplacental needle passage occurred in 147 cases ( 38.7%). Pregnancy loss rates were similar in the transplacental and no ntransplacental groups. Only the frequency of bloody taps was signific antly increased among women undergoing early transplacental amniocente sis. Conclusion: Transplacental needle passage in cases of amniocentes is performed before 14.9 weeks' gestation does not appear to increase the risk of pregnancy loss. Therefore, deferring early amniocentesis t o a later time at which nontransplacental amniocentesis may be perform ed should be reserved only for cases complicated by placental vessels, placental vascular lacuna (''placental lakes''), or subchorionic hema tomas that should not be traversed by a needle.