Five cases of brain injury following amniocentesis in mid-term pregnancy

This paper describes the neuroimaging and neuropathological findings in fiv e cases of severe brain damage after traumatic mid-trimester amniocentesis, all performed between 1986 and 1994. Although fetal injury after amniocent esis has been reported, reports of brain injury are infrequent. Continuous ultrasound monitoring may reduce the risk of fetal injury but follow-up ult rasound scans can be falsely reassuring. Withdrawal of blood-stained fluid, particularly if it contains tissue fragments, should alert the operator to the possibility of fetal damage. Histological examination of such tissue f ragments may confirm the nature of the fetal damage. The consequences of fe tal brain injury are severe, all five of our cases showed evidence of disru ption of brain development compatible with mid-term injury. Obstetricians a nd their patients should be aware of the small but significant risk of brai n damage after mid-term amniocentesis.