WELCOME

CLINICAL TEACHING ON:

AMNIOCENTESIS

PRESENTED BY:
AMRITHA S ANAND
Ist Year MSc Nursing
DEFINITION

Amniocentesis
is the deliberate
puncture of the
amniotic fluid sac
per abdomen.

OR
 Amniocentesis is a medical procedure used
in prenatal diagnosis of chromosomal
abnormalities and fetal infections in which
small amount of amniotic fluid which
contains fetal tissue, is extracted from the
amnion or amniotic sac surrounding a
developing fetus, and the fetal DNA is
examined for genetic abnormalities.
(WIKIPEDIA)
 INDICATIONS

Diagnostic:
 Earlymonths (14- 16 weeks): Antenatal
diagnosis of chromosomal and genetic
disorders like sex – linked disorders, inborn
errors of metabolism, neural tube defects, etc)
 Later months:
Fetal maturity
Rh incompatibilty
Infection
Meconium staining of liquor
Measurement of certain amniotic fluid
inflammatory markers will helps to identify
inflammation
 Therapeutic
At Ist half of pregnancy:
 Induction of abortion by instillation of
chemicals such as hypertonic saline, urea or
prostaglandins.
 Repeated decompression of the uterus in
acute hydramnios
 In second half of pregnancy:
 Decompression of uterus in unresponsive cases
of chronic hydramnios producing distress or to
stabilise the lie when it is not axial prior to
induction
 To give intrauterine fetal transfusion in severe
hemolysis folowing Rh – iso immunisation.
 Amnioinfusion: Infusion of warm normal saline
into the amniotic cavity is done trans
abdominally or transcervically to increase the
volume of amniotic fluid.
 PROCEDURE
 After emptying the bladder, the patient
remains in dorsal position.
 The abdominal wall is prepared aseptically
and draped.
 The proposed site of puncture is infiltrated
with 2 ml of 1 % lignocaine
 A 18 to 20 gauze spinal needle about 4”
in length is pierced into the mothers
abdominal wall, then through the wall
of the uterus, and finally into the
amniotic sac.
 With the aid of ultrasound guidance, a
physician punctures the sac in an area
away from the fetus and extracts
approximately 20 to 30 ml of amniotic
fluid
 After the amniotic fluid extraction, the fetal
cells are sperated from the sample. The cells
are grown in a culture medium, then fixed
and stained. Under a microscope, the
chromosomes are examined for
abnormalities such as downs syndrome,
edward syndrome and turners syndrome.
 In regard to the fetus, the puncture heals and
the amniotic sac replenishes the liquid over
the next 24 to 48 hours.
 PRECAUTIONS
 Poor sonographic localisation of placenta is
desirable to prevent bloody tap and feto - maternal
bleeding
 Prophylactic administration of 100 mg of anti D
immunoglobulin in Rh negative, non immunized
mother.
 Hazards are reduced significantly when it is done
‘under direct ultrasound control’ compared to the
blind procedure.
 HAZARDS
Maternal complications:
 Infection
 Haemorrhage
 Premature rupture of membrane and
premature labor
 Maternal iso immunisation in Rh – negative
cases.
 Fetal hazards:
 Abortion
 Trauma
 Feto – maternal hemorrhage
 Oligo hydramnios due to
leakage of amniotic fluid
and that may lead to fetal
lung hypoplasia, respiratory
distress and talipes
THANK YOU………….