title: Transabdominal Amniocentesis Is a Feasible and Safe Procedure in Preterm Prelabor Rupture of Membranes.
abstract: OBJECTIVE
  To determine the feasibility and the complication rate of amniocentesis in a large cohort of women with preterm prelabor rupture of membranes (PPROM).
  
  
  METHODS
  A retrospective cohort study was conducted in all women with singleton gestation complicated by PPROM at between 24+0 and 36+6 weeks admitted to the Department of Obstetrics and Gynecology, University Hospital Hradec Kralove, Czech Republic between May 2008 and July 2016. Amniocentesis was offered as a part of a routine protocol of PPROM for the detection of microbial invasion of the amniotic cavity and intra-amniotic inflammation. Procedure was performed under ultrasound guidance. A successful procedure was defined as obtaining at least 0.5 mL of amniotic fluid. No more than 2 attempts were performed.
  
  
  RESULTS
  In total, 590 women with PPROM were included. Amniocentesis was successful in 96% (567/590). Two amniocentesis attempts were necessary in 9% (55/590) and the transplacental approach was used in 13% (76/590). No association between gestational age at sampling and the amniocentesis failure rate was found (Spearman rho -0.12; p = 0.71). The complication rate was 0.7% (4/590). Two umbilical cord punctures and 2 chorionic plate fetal vessel injuries occurred, without fetal morbidity.
  
  
  CONCLUSIONS
  Based on our study population, so far the largest published, amniocentesis is a feasible and safe procedure carrying a very low risk of failure or complications in PPROM.
authors.affiliation: Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine in Hradec Kralove, University Hospital in Hradec Kralove, Hradec Kralove, Czech Republic.
authors.forename: Ivana
authors.initials: I
authors.lastname: Musilova
authors.forename: Tomas
authors.initials: T
authors.lastname: Bestvina
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Stranik
authors.forename: Martin
authors.initials: M
authors.lastname: Stepan
authors.forename: Bo
authors.initials: B
authors.lastname: Jacobsson
authors.forename: Marian
authors.initials: M
authors.lastname: Kacerovsky
mesh_terms: D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D062606:Tertiary Care Centers
keywords: Amniocentesis; Intra-amniotic infection; Intra-amniotic inflammation; Preterm rupture of membranes; Safety