Content 1. 2. 3. What is amniocentesis? Who is a candidate for amniocentesis? What can be detected through an amniocentesis? 4. Procedure 5. After procedure 6. Rapid test 7. Full karyotype 8. Result 9. Complications of amniocentesis 10. Conclusion What is amniocentesis? A procedure performed usually in the beginning of pregnancy to detect chromosomal abnormalities in the foetus. Usually done when a women is between 16 to 22 weeks of pregnancy. During this procedure a sample of amniotic fluid is taken from the amnion sac (amnion) surrounding the unborn baby and its DNA is examined for genetic abnormalities. The amniotic fluid- has skin cells of the developing body, as well as his/her waste products like urine. Each cell from the baby in fluid contains their complete set of DNA (genetic information). Analyzing these cells helps the doctors access the foetus health and detects any potential problems. The entire amniocentesis appointment lasts approximately 45 minutes –most of which involves a detailed ultra sound examination. Who is candidate for amniocentesis? Any pregnant woman who ,at her due date will be 40 years of age or older. Any women whose combitest results are high risk (blood tests and/ or foetal ultrasound). Any women whose ultrasound results indicate a potential foetal chromosomal abnormally. Any woman who has family history or whose partner has a family history of one or more incidents of chromosomal anomalies or genetic disorders with a high recurrence risk. It is also possible for women under the age of 40, with no history of genetic disorder to have an amniocentesis; it is a matter of personal choice. What can be detected through an amniocentesis? Nearly all chromosome disorder, including Down’s syndrome as well as sex chromosome abnormalities. Several hundred genetic disorders, such as cystic fibrosis and sickle cell disease. The test is not used to look for all of them, but if your baby is at increased risk for one or more of these disorders, in most cases amniocentesis can usually tell you whether he/she has the disease. Neural tube defects such as spina bifida. Amniocentesis is the only way to obtain information about fetal lung maturity. Amniocentesis is occasionally used late in pregnancy to assess whether the baby’s lungs are mature enough for the baby to breathe on his own. PROCEDURE 1. An ultrasound is used as a guide to determine a safe location for the needle to insert through the abdominal wall to enter the amniotic sac. So the fluid may be safely removed. 2. A sample of amniotic fluid is collected through the needle. The procedure takes about 45 minutes, although the collection of fluid takes less than five minutes. 3. The amniotic fluid, which contains cells shed by the foetus, is sent to the laboratory for analysis. After procedure Advised to rest for 24 hours No strenuous work or exercise for 72 hours No air travel for 72 hours Seek urgent medical attention ifo Feeling shivery o High fever of 38 degree Celsius or above o Persistent lower back pain and abdominal pain After the amniocentesis procedure, the sample of amniotic fluid (the fluid that surrounds the unborn baby in the womb) will be taken to a laboratory for testing. There are two different type of tests o a rapid test o A full karyotype Rapid Test A rapid test looks for abnormalities on specific chromosomes (the parts of the body’s cells that carry genes). We can get its reports within24-48 hours. A rapid test can identify a number of chromosomal conditions that cause physical and mental abnormalities. These are: o Down’s syndrome- symptoms are as follows 1. 2. 3. 4. 5. 6. 7. Flat facial features. Small head and ears. Short neck. Bulging tongue. Eyes that slant upward. Atypically shaped ears. Poor muscle tone. o Edward’s syndrome-- symptoms are as follows 1. Physical Abnormalities. Such as small and abnormally shaped head, abnormally small jaw and mouth, overlapping fingers and underdeveloped fingernails. Scrunched fists. Lowset ears. ... 2. Heart problems. 3. Developmental disorders. o Patau’s syndrome-- symptoms are as follows 1. 2. 3. 4. cleft lip and palate. an abnormally small eye or eyes (microphthalmia) absence of 1 or both eyes (anophthalmia) reduced distance between the eyes (hypotelorism) 5. problems with the development of the nasal passages. The results of a rapid test should be ready after three working days. This test is almost 100% accurate, but its only tests for the three conditions listed above. Full Karyotype Each cell in the body contains 23 pairs of chromosomes. A full karyotype checks all of these. The cells in the sample of amniotic fluid are grown for up to 10 days. In a laboratory before being examined under a microscope to check for: o The no. Of chromosomes o The appearance of chromosome Results from full karyotype will usually be ready in 2 or 3 weeks. In about 1 in every 100 tests, the results may not be clear. This could be due to the mother’s blood contaminating the sample of amniotic fluid, which may have prevented cells from growing properly. Down’s syndrome Edward’s syndrome Patau’s syndrome Result After amniocentesis, the sample of amniotic fluid is sent to a lab for analysis. Results usually take 10 days to three weeks depending on the lab It takes that long to get result because the cells have to grow in the lab in order to analyse them. In the lab, genetic and chemical test are done. For genetic tests, proteins, minerals and other compounds in the amniotic fluid are analysed. Amniocentesis results will either be positive or negative. Positive Test result Negative Test result If the test result is positive it means the baby has the disorder that was being tested for. One should be aware that there is no cure for the majority of chromosomal conditions, So she needs to consider her options carefully. For most women who have amniocentesis, results of the procedure will be negative. That is, there baby will not have any disorders that were tested for. Options may include : 1. Continuing with her pregnancy while getting information and advice about the condition. So, she is prepared for carrying for her baby. 2. Ending her pregnancy. 3. Options for ending her pregnancy will depend on how many weeks pregnant she is when making the decision. It is possible to have a negative result from amniocentesis but the baby may still be born with the condition tested for or another chromosomal condition. This is because a normal test result doesn’t exclude every chromosomal disorder. Complications of amniocentesis: It is important to be aware of the possible complications during or after amniocentesis. These are outlined below: Miscarriage: o There is a small risk that amniocentesis can cause a miscarriage (the loss of the pregnancy). The risk is estimated to be around 1 in 100. Club foot: o Amniocentesis may cause club foot in baby. This is when the baby is born with a deformed ankle and foot. However , the likely hood of this happening is higher if you have amniocentesis before week 15 of pregnancy. Rhesus Disease: o Rhesus disease is a condition where proteins in a pregnant woman’s blood attack her baby’s blood cells. o Rhesus disease is only possible if the mother’s blood is RHnegative and the baby’s blood is RH-positive. If this is the case, amniocentesis could trigger RH disease if the mother’s blood is exposed to the baby’s blood during the procedure. Injury from needle: o During amniocentesis, the placenta (the organ that links a mother ‘s blood to the baby’s blood) may be punctured by the needle. Sometimes this is necessary to access the amniotic fluid. If this happens, the puncture wound usually heals without any problems developing . o Ultrasound (where high frequency sound waves are used to create images) is now commonly used to guide the needle. This significantly reduces the risk of injury from the needle. Infection: o In very rare cases, an infection may develop if the procedure introduces bacteria in the amniotic sac (the sac surrounding the foetus that contains amniotic fluids). This can cause: A high temperature (fever) of 38-39 degree Celsius or above Tenderness of abdomen (tummy) Contractions (when your abdomen tightens then relaxes). One should seek medical attention if she has any of these symptoms. The risk of developing a serious infection from amniocentesis is estimated to be less than 1 in 1000 Conclusion Amniocentesis is a safe procedure that can provide helpful information about the health of foetus. It may be offered to be a woman who is at high risk of having a baby with a genetic disease. The risk of miscarriage of amniocentesis is about 0.5% or 1 in 200. It is the patient’s decision whether the benefits of procedure out-weigh the risks. BIBLIOGRAPHY 1. https://www.mayoclinic.org/testsprocedures/amniocentesis/about/pac-20392914 2. https://americanpregnancy.org/prenataltesting/amniocentesis/ 3. https://www.google.com/search?q=amniocentesis&rlz= 1C1CHBD_enIN894IN894&hl=enUS&source=lnms&tbm=isch&sa=X&ved=2ahUKEwijqtLCl L3pAhVqwTgGHYJXCNcQ_AUoAXoECBYQAw&biw=1366 &bih=625 4. https://en.wikipedia.org/wiki/Amniocentesis 5. Ncert biology book of class 12th