Maba Name : Chintya Clara Abidha Dewantari

Garda Name : Obstetrics

AMNIOCENTESIS

Amniocentesis is the examination used to test chromosomal abnormalities, genetic

disease, an infection of the fetus, evaluate lung maturity and can be used in the treatment of
conditions hidramnion. Nowadays, amniocentesis has been widely used by people. These
checks are carried out on pregnant women aged over 35 years with prenatal screening test
results are positive, a history of a specific genetic disorder in the family and the history of
genetic abnormalities in a previous pregnancy. The timing of amniocentesis are 15-18 weeks
gestation. In the US usually done early amniocentesis, at 10-14 weeks gestation. However,
because of the high potential to become a PROM (Premature Rupture Of Membrane),
infection and bleeding, so that amniocentesis is rarely performed in this age. Amniocentesis
is performed in the second trimester showed no significant risk to the occurrence of ELBW
(Extremely Low Birth Weight, Less Than 1000 g) or VLBW (Very Low Birth Weight, Less
Than 1500 g). The presence of active skin infection at the site of puncture amniocentesis,
amniotic bit number (hidramnion), as well as the placenta covering the anterior wall of the
uterus is contraindicated doing these checks.

Transabdominal amniocentesis is an invasive procedure. Ultrasonography (USG) is

used as a guide in conducting aspiration of amniotic fluid using a spinal needle size 20-22 G.
The needle is directed directly towards the amniotic bag to avoid fetal and umbilical cord
without crossing the placenta. Local anesthesia is not commonly used because of the
inconvenience caused at the time of taking the amniotic fluid is relatively small. A total of 20
ml of amniotic fluid is taken for use in the analysis of chromosomes. Once completed,
observations bleeding in the former location of the injection needle in the uterus. In addition
to the documentation done fetal heart motion at the end of the procedure. Amniotic fluid is
then sent to the laboratory for culture and examination karyotype. This examination takes 7-
10 days.

Amniocentesis slightly increase risk of miscarriage, especially if performed before 15

weeks' gestation. To lower this risk, amniocentesis is performed by physicians who are
competent and experienced. It is not certain why there may be little possibility of
amniocentesis leads to miscarriage. It could be caused by infection, bleeding, use of needle
size, the experiment many times, chorioamnionitis after amniocentesis or amniotic membrane
damage caused by the procedure. In addition, it could also be caused due to undergo
amniocentesis with gestational age below 15 weeks. Miscarriage happens after amniocentesis
procedure was reported as one of the 300-500 cases. This miscarriage increased 2 times in
women with class 3 obesity (BMI 40 kg / m2). A total of 66 fetal deaths were reported on
12,000 amniocentesis procedures on both trimeseter which as many as 12% of which are
caused due to an intrauterine infection that already exists. Other complications that can occur
include the leakage of amniotic fluid (1-2%) and chorioamnionitis (0.1%). In addition to risk
of miscarriage, amniocentesis is also at risk of infection. Approximately 1 in 1,000 pregnant
women undergoing amniocentesis have a serious infection in the amniotic fluid. Infection can
be caused by injury to the intestine with a needle used in the procedure, germs in the skin
(abdomen) is also entered with a needle into the abdominal cavity or the womb, germs in the
ultrasound device or jelly ultrasound, have been introduced into the abdominal cavity. There
is also the risk of injury to the fetus with a needle used having an amniocentesis. However,
with ultrasound guidance unbroken for amniocentesis has lowered the possibility of this
complication and is now very rare.

References
Irianti, Bayu, Dkk. 2014. Asuhan Kehamilan Berbasis Bukti. Jakarta: CV Sagung Seto.
Leven, Kenneth J, dkk. 2013. Obstetri William. Jakarta: Penerbit Buku Kedokteran EGC.
dr. I Putu Cahya Legawa. 2015. Amniosentesis. http://dokter.legawa.com/?p=290. Accessed
on 25st August. At 20.00
Summase, S.pd. 2014. Amniosentesis: Diagnosa Kelainan dan Gangguan Kesehatan Janin dalam
Kandungan. http://www.infosehatkeluarga.com/amniosentesis-diagnosa-kelainan-dan-
gangguan-kesehatan-janin-dalam-kandungan/. Accessed on 25st August. At 21.00
dr. I Nyoman Rudi Susantha, Sp.OG. 2015. AMNIOSENTESIS.
http://idigianyar.org/artikelidigianyar.php?page_detil=11. Accessed on 26st August. At 09.00