An overview of a 30-year experience with amniocentesis in a single tertiary medical center in Taiwan.
OBJECTIVE
Amniocentesis is a popular and effective prenatal diagnostic tool for chromosomal disorders. It is well-established that the risk of chromosomal abnormalities increases with maternal age; however, other related indications are seldom reported. Herein, we report our 30-year experience with amniocentesis from a single medical center, focusing on the indications and rates of abnormality.


METHODS
A retrospective review of 16,749 pregnant women in the mid-trimester between January 1981 and December 2010 was conducted. The medical records were analyzed.


RESULTS
The indications for amniocentesis were advanced maternal age (≥ 34 years old) (n=10,970, 65.5%), increasing-risk maternal triple-marker Down's screening test (≥ 1/270) (n=2090, 12.5%), history of abnormal offspring birth (n=792, 4.7%), abnormal ultrasound findings (n=484, 2.9%), parent with abnormal karyotype (n=252, 1.5%), family history of chromosomal abnormality (n=183, 1.1%), drug and radiation exposure (n=165), abnormal chorionic villus sampling (CVS) results (n=25), intrauterine fetal death (n=50), and other non-specific causes (n=1662, 9.9%). The rate of abnormality for each indication was 16% in the abnormal CVS group, 12% in the intrauterine fetal death group, 11.5% for parental chromosomal abnormality, 8.7% in the abnormal ultrasound finding group, 3.0% in the increasing-risk maternal triple-marker Down's screening test group, 2.5% in the advanced maternal age group, 1.5% for other non-specific causes, 1.4% for history of abnormal offspring birth, and 1.1% for family history of chromosomal abnormality.


CONCLUSIONS
Both parents with abnormal karyotype and abnormal ultrasound findings are indications for which consideration of further amniocentesis is highly recommended.
Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan.
Yi-Wen
YW
Chang
Chia-Ming
CM
Chang
Pi-Lin
PL
Sung
Ming-Jie
MJ
Yang
Wai Hou
WH
Li
Hsin-Yang
HY
Li
Ling-Chao
LC
Chen
Ling-Yi
LY
Cheng
Yu-Ling
YL
Lai
Yung-Yung
YY
Cheng
Wen-Hsun
WH
Chang
Kuan-Chong
KC
Chao
Peng-Hui
PH
Wang
D000649:Amniocentesis; D015193:Chorionic Villi Sampling; D002869:Chromosome Aberrations / Q000139:chemically induced / Q000528:radiation effects; D004314:Down Syndrome / Q000175:diagnosis / Q000235:genetics; D005260:Female; D005313:Fetal Death / Q000235:genetics; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000235:genetics*; D030342:Genetic Diseases, Inborn / Q000000981:diagnostic imaging / Q000235:genetics*; D006801:Humans; D059785:Karyotype; D008423:Maternal Age; D011237:Predictive Value of Tests; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan; D016216:Ultrasonography, Prenatal