Hernández-Andrade E, Leis-Marquez MT, Ahued-Ahued R

Language: Spanish
References: 27
Page: 7-13
PDF size: 257.95 Kb.

ABSTRACT

Objective: To identify complications associated with and without continuous guided ultrasound amniocentesis.
Material and methods: Between 1990 and 1997, 473 diagnostic amniocentesis were evaluated in 165 high risk pregnant women (2.8 procedures per case), 197 were made without continuous ultrasound guidance and 276 with continuous ultrasound guidance. Major complications were defined as those ones which ended in the termination of pregnancy, i.e. rupture of the chorioamniotic membranes, transvaginal hemorrhage and non-controlled uterine contractions. Minor complications were defined as those ones present in the 72 hours period after the amniocentesis which not-ended in the termination of pregnancy; increased number of punctions, hematic contamination of the sample, controlled uterine contractions and transvaginal discharge. The analysis was made with Chi square for proportions.
Results: In the non-continuous guided ultrasound amniocentesis group, 197 procedures and 68 pregnant women were included (2.89 procedures per case). A total of 62 complications were observed (31.46%), 5 major (2.53%) and 57 minor (28.93%). In the continuous guided ultrasound amniocentesis group, 276 procedures and 97 pregnant woman were included (2.84 procedures per case). A total of 22 complications were observed, 2 major (0.72%) and 20 minor (7,24%). Chi square analysis shows a value of 86.435 with a p value of 0.0001
Conclusion: The use of continuous guided ultrasound amniocentesis decreases the risk of complications in 3 or 4 times compared with the non-continuous guided ultrasound amniocentesis. It is recommended that all the diagnostic procedures to access the fetal health status must be performed under continuous ultrasound guidance.

REFERENCES

1. Grether P, Zavaleta MJ, De La Luna E, Sánchez Solis V, Hernández C, Karchmer S. Diagnóstico prenatal en 350 amniocentesis. Ginecol Obstet Mex 1991; 59: 317-22.

2. American College of Obstetricians and Gynecologists ACOG educational bulletin. Management of isoimmunization in pregnancy. Int J Gynaecol Obstet 1996; 55: 183-90.

3. Garza Fernandez-L, Cabra Zurita R, Grether P, Garcia Leon F, Kably Ambe A. Estudio analítico de la amniocentesis en el diagnóstico genético prenatal. Estudio transversal de casos. Ginecol Obstet Mex 1998; 66: 237-41.

4. Violante Diaz-M, Carrillo Hinojosa M, Garcia Necoechea MP, Escobedo Aguirre F, Lowenberg Favela E, Ahued Ahued JR. Amniocentesis genética. Ginecol Obstet Mex 1989; 57: 97-102.

5. Cerrillo M, Violante M, Garcia P, Yerena MC, Escobedo F, Lowenberg E, Ramirez S. Diagnóstico citogenético prenatal. Inicio de una nueva etapa dentro de la citogenética en México. Ginecol Obstet Mex 1986; 54: 107-11.

6. Teuscher Cortes P, Gomez Lozano L. Amniocentesis, transfusión fetal intrauterina y control radiológico. Técnicas y consideraciones clínicas. Ginecol Obstet Mex 1966; 21: 323-31.

7. Werch A. Amniocentesis: indications, technique and complications. South Med J 1976; 69: 824-7.

8. Velázquez A, Lowenberg Favela E, Del Veccio N, Carnevale A, Nino de Rivera O, Castillo J. Diagnóstico prenatal de enfermedades genéticas. Resultados preliminares. Ginecol Obstet Mex 1978; 44: 395-400.

9. Garcia Alonso-A, Lopez Garcia R, Lozano de la Garza J, Avila Gamboa D, Karchmer S. Complicaciones materno-fetales derivadas de la amniocentesis. Ginecol Obstet Mex 1978; 44: 267-73.

10. 10 Bantock H, Sutherland I. Risks of amniocentesis [letter] . Lancet 1979; 2: 788.

11. Weiss R, Ebert R, Dichter J, Macri JN, McLaughlin SE. Risks of amniocentesis [letter]. Lancet 1979; 2: 578.

12. Roberts NS, Dunn LK, Weiner S, Godmilow L, Miller R. Midtrimester amniocentesis. Indications, technique, risks and potential for prenatal diagnosis. J Reprod Med 1983; 28: 167-88.

13. Murray JC, Karp LE, Williamson RA, Cheng EY, Luthy DA. Rh isoimmunization related to amniocentesis. Am J Med-Genet 1983; 16: 527-34.

14. 14 Crane JP, Rohland BM. Clinical significance of persistent amniotic fluid leakage after genetic amniocentesis. Prenat Diagn 1986; 6: 25-31.

15. Williamson RA, Varner MW, Grant SS. Reduction in amniocentesis risks using a real-time needle guide procedure. Obstet Gynecol 1985; 65: 751-5.

16. Porreco RP. Assessing risks of midtrimester amniocentesis [letter]. Am J Obstet Gynecol 1985; 152: 917-8.

17. Hanson FW, Zorn EM, Tennant FR, Marianos S, Samuels S. Amniocentesis before 15 weeks´ gestation: outcome, risks, and technical problems. Am J Obstet Gynecol 1987; 156: 1524-31.

18. Finegan JA. Amniotic fluid and midtrimester amniocentesis: a review. Br J Obstet Gynaecol 1984; 91: 745-50.

19. Leschot NJ, Verjaal M, Treffers PE. Risks of midtrimester amniocentesis; assessment in 3000 pregnancies. Br J Obstet Gynaecol 1985; 92: 804-7.

20. Bowman JM, Pollock JM. Transplacental fetal hemorrhage after amniocentesis. Obstet Gynecol 1985; 66: 749-54.

21. Olivas Mendoza G, Vargas Lopez E, Pinales Baena H, Salinas Molina RR. Amniocentesis diagnóstica. Ginecol Obstet Mex 1979; 46: 163-71

22. Amor Calleja L, Garcia Alonso A, Garcia Tagle JE, Osorno Covarrubias-LR. Utilidad del ultrasonido en la transfusión fetal intrauterina: presentación de un caso. Ginecol Obstet Mex 1985; 53: 319-25.

23. Carter CO. Risks of miscarriage after amniocentesis. J Med Genet 1976; 13: 351.

24. Bartsch FK, Lundberg J, Wahlstrom J. One thousand consecutive midtrimester amniocenteses. Obstet Gynecol 1980; 55: 305-8.

25. O´Brien WF. Midtrimester genetic amniocentesis. A review of the fetal risks. J Reprod Med 1984; 29: 59-63.

26. Liley AW. Diagnosis and treatment of erythroblastosis in the fetus. Avd Ped 1968; 15: 29.

27. Scott F, Chan FY. Assessment of the clinical usefulness of the ‘Queenan’ chart versus the ‘Liley’ chart in predicting severity of rhesus iso-immunization. Prenat Diagn 1998; 18: 1143-8.