Test Overview
Amniocentesis is a test to look at the fluid (amniotic fluid) that surrounds your
baby (fetus). Amniotic fluid has cells and other
substances that can give clues about the health of your fetus. Amniocentesis is
done by gently putting a needle through your belly into your
uterus. About
2 Tbsp (30 mL) of the amniotic
fluid is taken out and looked at.
Amniocentesis is generally done
between weeks 15 and 20 (usually around week 16) to look at genetic
information. It can also be used later in pregnancy to see how the fetus is
doing.
Amniocentesis for birth defects testing
Amniocentesis is often done around
week 16 to see whether a fetus has certain types of birth defects.
Amniocentesis can also tell the sex of your fetus.
Amniotic fluid
has cells that have been shed by your developing fetus. The cells are checked
for the number and size of
chromosomes (karyotype) to see if there are any
problems that put the baby at risk for certain conditions. Testing is most
commonly done as early as possible so that women and their families have time
to consider their options. But amniocentesis cannot find many common birth
defects, such as
cleft lip,
cleft palate, heart problems, and some types of intellectual disability.
-
Pregnancy: Should I Have Amniocentesis?
Amniocentesis in late pregnancy
If you are at risk
of having your baby early, amniocentesis may be done during the third trimester
to see whether your baby's lungs are developed. Your developing fetus makes
substances that can be found and measured in amniotic fluid. The amounts of
these substances show how mature the lungs are and if your baby will be able to
breathe without help if delivered early.
Amniocentesis may also be
done later in pregnancy if an infection of the amniotic fluid
(chorioamnionitis) is suspected.
Why It Is Done
Amniocentesis
may be done during your second trimester of pregnancy
to find certain birth defects.
You may choose to have this test because:
- Of your age. As you get older, you have a greater chance of having a baby with a birth defect. Many doctors use 35 and older as the age for higher risk.
-
You want to know for sure if your baby has a certain health problem. This may help you decide early whether you want to continue your pregnancy or make plans to care for a sick child.
- You or the baby's father carries an abnormal gene that is known to cause a disease, such as Tay-Sachs disease,
sickle cell anemia, or
cystic fibrosis.
- You or the baby's father has a family history of a genetic disorder or birth defect.
- Screening tests suggest that your chance of having a baby with a genetic disorder or birth defect is higher than average.
Amniocentesis can tell the gender of your fetus. This is
important when you or the father may be able to pass on a disease that occurs
mainly in one gender (sex-linked), such as
hemophilia or
Duchenne muscular dystrophy, both of which occur
mainly in males.
Amniocentesis may be done during your third
trimester to:
- See if your fetus's lungs are mature. This may be done when you
may need to deliver early because of a problem with the
pregnancy.
- See whether the amniotic fluid is infected
(chorioamnionitis).
How To Prepare
You will be asked to empty your bladder
just before the test.
You will need to sign a consent form that
says you understand the risks of the test and agree to have it done.
Talk to your doctor about any concerns you have about the need for the test,
its risks, how it will be done, or what the results will mean. To help you
understand the importance of this test, fill out the
medical test information form(What is a PDF document?).
How It Is Done
Amniocentesis
is done by your
obstetrician in his or her office or in the hospital.
An overnight stay in the hospital usually is not needed unless problems occur
during the test.
You will be asked to expose your belly. You will
then lie on your back with it slightly raised to relax your belly muscles. Your
lower belly will be cleaned with a special soap.
Your doctor
checks the position of your fetus and the
placenta with a fetal ultrasound. Ultrasound uses
sound waves to make a picture of the uterus, your fetus, and the placenta on a
TV screen. Your fetus's heart rate can also be watched during the test using
ultrasound. For more information, see the topic
Fetal Ultrasound.
With the
ultrasound picture as a guide, your doctor gently puts
a thin needle through your belly and into your uterus without hurting your
fetus or the placenta. If your fetus moves too close to the needle, the needle
will be taken out and your doctor will try again in another spot.
About 2 Tbsp (30 mL) of
amniotic fluid is taken out in a syringe attached to the needle, and then the
needle is taken out. The site is covered with a bandage.
The whole test takes
about 15 minutes. The thin needle is only in your belly for 1 to 2 minutes.
Your fetus's heart rate and your blood pressure, pulse, and breathing will be
checked before, during, and after the test.
How It Feels
You will feel a sharp sting or burn in
your belly where the needle is inserted. This lasts for only a few seconds.
When the needle is put into your uterus, you again will feel a sharp cramp for
a few seconds.
When the amniotic fluid is taken out, you may get a
feeling of pulling or pressure in your belly. To keep yourself comfortable,
breathe slowly and relax your belly muscles during the test.
Risks
Amniocentesis is generally very safe. There is a
chance (about 1 out of 400) that this test may cause a miscarriage.1 In some studies, the risk is a little higher, about 2 to 4 out of 400.2 There is also a risk of too much bleeding
(hemorrhage), infection of the amniotic fluid (amnionitis), or leakage of
amniotic fluid. In very rare cases, a fetus may be poked by the needle during
the test. Your doctor does all he or she can to put the needle in a safe spot.
Most fetuses float away from the needle tip.
Amniocentesis has a
very small risk of causing bleeding that could lead to mixing your blood and
your fetus's blood. So if you have Rh-negative blood, you will be given the
Rh immunoglobulin vaccine (such as RhoGAM) to prevent Rh sensitization, which
could harm your fetus if he or she has Rh-positive blood.
After the test
After the test, you may have some
mild cramping. You should not do any strenuous activity for several hours after
the test. Also, do not douche, use tampons, or have sex after the test. By the
next day, you can do your normal activities, unless your doctor tells you not
to.
Call your doctor right away if:
- You have moderate or severe belly pain or
cramping.
- You develop a fever.
- You become
dizzy.
- Fluid or blood leaks from your vagina or from the needle
site.
- Redness or swelling develops at the needle site.
Results
Amniocentesis is a test to look at the
fluid (amniotic fluid) that surrounds your
baby (fetus).
Normal amniotic fluid is
clear to light yellow in color and does not contain any harmful bacteria. The
cells can be tested for problems.
- Cells from your fetus are looked at carefully
for the proper number and arrangement of the cell parts (chromosomes) that show genetic disease. Normally there
are 46 chromosomes in each cell, arranged in 23 pairs. Chromosomes also tell
the gender of your fetus.
- The amounts of some substances in the
amniotic fluid may be measured. These results can find some birth defects,
genetic diseases, and the maturity of your fetus.
What Affects the Test
Reasons you may not be able to
have the test or why the results may not be helpful include:
- If there is blood from your fetus in the amniotic fluid. This can
falsely increase the level of the substances alpha-fetoprotein (AFP) and
acetylcholinesterase (AChE) levels, which test for
neural tube defects.
- If the amniotic fluid
is exposed to light. This can falsely lower bilirubin levels.
- If
there is blood or meconium in the fluid. This may cause an incorrect result for
the test that checks to see whether your baby's (fetus's) lungs are
mature.
What To Think About
- Normal results from amniocentesis do not
guarantee that your fetus will be healthy.
- Amniocentesis can be
done to help you prepare if your fetus has a possible birth defect or to help
you make a decision about ending the pregnancy if a serious problem is found.
- Pregnancy: Should I Have Amniocentesis?
- In very rare cases, amniocentesis may be done before 15 weeks of pregnancy. This is rare, because there may be greater risks to your fetus. Talk to your doctor about the risks and benefits of early amniocentesis.
- Amniocentesis can't be done easily if the amount of
amniotic fluid is very small or if the placenta is in front of your
fetus.
-
Chorionic villus sampling (CVS)
is another test that
can find many fetal problems. CVS can be done earlier in pregnancy than amniocentesis, and results are ready sooner. For more
information, see the topic
Chorionic Villus Sampling (CVS).
- Amniocentesis has a very small
chance of causing bleeding that could lead to mixing your blood and your
fetus's. So if you have Rh-negative blood, you will be given a vaccine (RhoGAM)
to prevent Rh sensitization, which could harm your fetus if he or she has
Rh-positive blood.
- Amniotic fluid has cells that have been shed by
your developing fetus. The cells are checked for the number and size of
chromosomes (karyotype) to see if there are any problems. For more information,
see the topic
Karyotype Test.
- If you have abnormal results from amniocentesis, you should ask
your doctor or a
genetic counselor for help in making decisions about
the problems your fetus may have and about continuing the pregnancy. It will
also be helpful to understand your possible risks with future
pregnancies.
References
Citations
-
Caughey AB, et al. (2006). Chorionic villus sampling compared with amniocentesis and the difference in the rate of pregnancy loss. Obstetrics and Gynecology, 108(3): 612–616.
-
Seeds JW (2004). Diagnostic mid trimester
amniocentesis: How safe? American Journal of Obstetrics and Gynecology, 191: 608–616.
Other Works Consulted
- American College of Obstetricians and Gynecologists
(2007, reaffirmed 2009). Invasive prenatal testing for aneuploidy. ACOG Practice Bulletin No.
88. Obstetrics and Gynecology, 110(6):
1459–1467.
- Wapner RJ, et al. (2009). Prenatal diagnosis of congenital disorders. In RK Creasy et al., eds., Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice, 6th ed., pp. 221–274. Philadelphia: Saunders Elsevier.
Credits
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By
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Healthwise Staff |
|
Primary Medical Reviewer
|
Sarah Marshall, MD - Family Medicine |
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Specialist Medical Reviewer
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Siobhan M. Dolan, MD, MPH - Reproductive Genetics |
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Last Revised
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April 4, 2012 |