Genetic amniocentesis complications: is the incidence overrated?
OBJECTIVE
To estimate the complication rate of 2nd-trimester amniocentesis and to determine the associated risk factors.


METHODS
A retrospective chart review of genetic amniocenteses performed at a single tertiary care institution, from 1996 to 1998, was done. The variables studied included gestational age, indication for amniocentesis, number and site of needle punctures, and amniotic fluid color. Complications included fetal loss, rupture of membranes, and bleeding.


RESULTS
Out of the 1,347 procedures analyzed, the most common indications were advanced maternal age (72.3%) and abnormal triple screen (20.3%). Transplacental genetic amniocenteses totaled 234 (17.4%). Clear fluid was observed in 98.2% of the patients. Twenty-two complications (1.6%) were observed: fetal loss (0.22%), bleeding (0.59%), and rupture of membranes (0.82%). An abnormal karyotype was detected in 34 (2.5%) fetuses. In separate univariate logistic regression analyses, complications were significantly associated with gestational age [odds ratio OR = 1.19; 95% confidence interval CI = (1.08, 1.32); p = 0.001], number of punctures [OR = 8.2; 95% CI = (1.76, 37.97); p = 0.007], and ultrasound anomalies [OR = 5.82; 95% CI = (1.65, 20.58); p = 0.006]. Gestational age and number of punctures remained significant in multivariate logistic regression analysis.


CONCLUSIONS
Genetic amniocentesis performed at a tertiary care institution is rather safe, and the fetal loss rate of 0.22% is significantly lower (p < 0.001) than the previously published incidence of 1/200. The risk of complications is significantly and independently associated with advanced gestational age and number of punctures.
Nassar
Anwar H
AH
Division of Perinatology, Department of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, Fla., USA. an21@aub.edu.lb
Martin
Dibe
D
González-Quintero
Victor Hugo
VH
Gómez-Marín
Orlando
O
Salman
Fawwaz
F
Gutierrez
Alfredo
A
O'Sullivan
Mary J
MJ
D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005313:Fetal Death; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology / Q000209:etiology*; D005500:Follow-Up Studies; D005820:Genetic Testing; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D015999:Multivariate Analysis; D007752:Obstetric Labor, Premature / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D014592:Uterine Hemorrhage / Q000453:epidemiology / Q000209:etiology*