Any sane individual would be right to question why a mom-to-be would ever allow a doctor to stick a huge needle into her pregnant belly. Some women would never allow amniocentesis, no matter what, when, or why. On the other hand, others feel there are several good reasons to have the test done as soon the timing is right.
Amniocentesis is a diagnostic test, where a doctor collects a bit of amniotic fluid, and is sometimes recommended by a health care practitioner after other tests give abnormal readings. One test returning abnormal readings that would cause a doctor to recommend an amniocentesis is the Triple Test. The Triple Test, also known as Multiple Marker Screening or AFP Plus is a maternal blood screening test that looks for three substances: AFP, hCG, and Estriol. Other reasons doctors recommend amniocentesis is to determine if specific genetic disorders may be present in certain babies.
The whole process of amniocentesis takes about 45 minutes. The doctor uses an ultrasound as a guide to determine a safe location for the needle to enter the amniotic sac where the fluid can safely be removed. The doctor usually removes about a tablespoon or two or fluid (which will replenish itself) through the needle and this part only takes about five minutes. The amniotic fluid that is collected contains cells shed by the fetus and its sent to a lab for analysis. This type of testing is usually done in the second trimester, although it can in some cases be done as early as the first trimester or as late as the third. Here are 7 reasons reasons to seriously consider an amnio and 5 reasons to totally skip it.
The first reason on this list is a little bit puzzling. Sometimes doctors recommend an amnio procedure if the membranes rupture prematurely, or in other words, if the water breaks before it’s supposed to break. But a quick search online will bring up several women saying they believed their water broke because of an amnio. While most studies do suggest about a 1% chance of the membranes rupturing after an amnio, one might conclude that that one percent of women is fully represented online.
The reasons some doctors recommend an amnio after a premature rupture is to test whether there is an infection present inside the uterus which may pose a danger to the mother or the baby. Typically, after the membranes rupture, the contractions will begin within 12 to 48 hours; however, if the baby is early (or before 34 weeks) it may take 4 days or more for contractions to start.
The number one risk associated with amniocentesis is miscarriage. The risks of miscarriage ranges from 1 in 400 or about 0.25 percent all the way up to 1 in 200 or 0.5 percent. The more this procedure is done in a facility, the lower the rates are. The reasons miscarriages occur are infections in the uterus, the water breaking, or labor being induced prematurely following the procedure.
Since an amnio pokes a small hole in the amniotic filled sac, the fetus is living and growing inside the mother’s womb, and sometimes that puncture can cause the membranes to rupture. If they rupture too early, the baby will be born before its lungs can function properly or other life threatening situations can arise. Miscarriage is the number one reason on women’s list of reasons to avoid the procedure. They don’t want to risk ending the pregnancy.
Sometimes mom's and baby's blood does not "get along". It's called Rh incompatibility. If the mom or in some cases the dad has Rh positive or negative blood and the baby's is the opposite (in the dad's case, if he has passed on a genetic trait for the baby to have a different type than the mom), the mom's blood cells might attack the baby's blood cells. In severe cases it can cause the developing baby to have problems getting oxygen.
While this isn't typically much of a problem in first pregnancies, because the baby "gets out of there" before too many issue develop during delivery, subsequent pregnancies can be problematic because the mom may have developed antibodies because of the first baby. For this reason, some doctors may suggest an amnio to test whether the baby's Rh is incompatible with mom's and if so, how severe it is, because in some cases babies require life saving blood transfusions at birth.
Another one of the strongest (and possibly most vocal) arguments against amnio procedures is that some parents just don’t care what the testing would reveal. It would not make a difference to these parents whether the baby was born with some kind of disability or genetic disorder or even if the baby was only able to live for a short time after birth due to some malignancy. They still would not change a thing.
They counter the argument of people that choose to do the amnio because they want to better prepare for possible difficulties with the argument that some of those people may opt to end the pregnancy if they hear some news they don’t like or feel they could not handle. And that’s not a decision these parents could or would ever make.
As stated earlier, most of the time, amnio procedures are done between the 14th and the 20th week, however, sometimes an amnio procedure may be done right before birth. It is occasionally used well into the final part of the third trimester to determine whether the baby’s lungs are mature enough for the baby to be able to breathe on its own following delivery. So, for a woman with a long drive to a hospital that has the right equipment to help a newborn breathe shortly after birth, it might be a good idea to have this test done, if there are any indications that this sort of problem might arise.
Although, some would argue that an amnio may not give an exactly accurate reading due to other things (like blood and certain tissues) interfering with the test, and that there might be better ways to gather that information making the amnio procedure a thing of the past.
No sane parent would ever cause unnecessary harm to their child and that sense of protection starts well before birth. Countless moms have spent hours online and waiting on hold to talk to nurses because they bumped their pregnant belly against something, or another child accidentally kicked or punched their pregnant tummy. So, putting a needle into something that not only resembles a balloon but also is carrying an unborn child is unfathomable.
There is a risk during an amnio that the needle could come into contact with the child. While they do use an ultrasound to show the doctor where to go during the procedure, accidents (although rare) do happen. If the baby approaches the needle the doctor can quickly move it away and keep the baby safe. Amnios is not a new procedure, it has been done before the ultrasound could help the doctor to see what they were doing. For this reason alone, it is said to be a bit safer these days.
Amnios can detect chromosome abnormalities rather accurately. One of the most common chromosome abnormalities is Down Syndrome, also known as Trisomy 21. Down syndrome affects about 1 out of every 800 babies born in the United States, which means as many as 6000 babies are born with Down syndrome every year. Many people think Down syndrome is called “down” syndrome because down relates to the delays or something having to do with the conditions or symptoms of the syndrome. But Down was actually the name of the doctor who described the condition.
Dr. Langdon Down was one of the first doctors to write about some of patients all having the some of the same traits and characteristics. Babies born with Down syndrome simply have an extra 21st chromosome, which cause differences as the baby develops. Parents choosing to get an amnio to discover whether this is the case, argue they can better prepare for life with a child that has this syndrome.
Anytime there is a large needle involved there is typically pain. This is no different; although interestingly enough, there are more places that can hurt! Moms-to-be report feeling pain when the needle enters the skin on the stomach and again when it enters the uterus. How about that sorry “two for one” deal? Other side effects associated with an amnio procedure include cramping, which could be similar to period or even slight labor pains, leaking of fluids, and irritation where the needle entered the skin.
As discussed earlier, the leaking of fluid can be a cause for worry, when it signals the water breaking (membrane rupturing) or the start of labor well before the proper timing. So, how many women would leap to add yet another discomfort to the spectrum of pregnancy aches and pains? Well, I’d argue, not many without an important need to get the testing done.
Another reason some parents and doctors opt for an amnio procedure is that the testing is very good at detecting neural tube defects. A neural tube defect is a birth defect of the brain, spine, and spinal cord. One of the most common neural tube defects is spina bifida. Spina bifida is when the spinal column of the baby does not close properly or completely. It develops during the very first month of pregnancy.
There are many forms of spina bifida, some severe and others less severe. Some of the most dramatic cases involve children having fluid in the brain which requires a lifelong shunt to be surgically placed to drain the fluid. Other conditions include either full or partial paralysis, problems going to the restroom or bladder control issues, learning disabilities and other difficult circumstances.
Finally, the last reason some women choose to skip the amnio procedure altogether combines many reasons into one very simple one: they just choose not to do it, and say it is not worth it. There are many religions which would say this procedure infringes on the rights of an unborn baby and mother. Some people aligned with pro-life principles say it justifies abortions, and that it is wrong to find out information about a baby before it is born and make decisions about that life without ever consulting the baby (as a person) itself.
For many women, the reasoning is more personal. They just can’t bring themselves to do it or to chance losing a pregnancy some work so hard to get. Whatever the reason, women choose to or choose to forgo the amnio procedure; it’s important that they are well informed. As one women said, she didn’t know the harm the procedure could have caused her baby that ended up being born too early after a premature membrane rupture following the procedure.
Another mom wishes she had gotten one so she could have known her baby would’ve needed the lifesaving breathing equipment that was too far away at another hospital after she gave birth. Women need to do their own research and decide what’s best for them.
Genetic disorders are also easily detected when the fluid taken during the amnio is processed and analyzed. Many parents with genetic predispositions to certain disorders readily go in for amnio procedures to learn and best prepare for possible outcomes. One genetic disorder that can be tested for is cystic fibrosis. Cystic fibrosis is a difficult disease that actually gets worse with time. People that suffer from cystic fibrosis get reoccurring lung infections, and eventually the ability to breathe begins to increasingly diminish.
The perpetrator is the disease is a defective gene that produces thick mucus to build up in the lungs, pancreas, and other organs. When this nasty mucus builds up in the lungs, it clogs the airways and traps bacteria that causes infections which can lead to lung damage, and even respiratory failure. When the mucus enters and gets stuck in the pancreas, it prevents the digestive enzymes from being able to break down food and blocks the body from absorbing important nutrients.
Move over Jerry Springer, there is no longer a need for the tacky show featuring the women wanting to know who or which man is the father of their child or children. Those uncomfortable shows that most people can hardly seem to unglue their eyes from just might be a thing of the past. These days technology can show “who is the daddy” before the baby is even born.
Amniocentesis provides early access to DNA which can be used for identifying the father, otherwise known as paternity testing. DNA can be collected from the “said” father (using various methods) and can be compared to the DNA provided from the baby during the amnio procedure. The results are almost 100% accurate; studies show a 99% chance of determining a match. So, there will be no second guessing this test result.
Sources: Mfama.com, NHLBI.nih.giv, YourDevelopingBaby.com