Retrospective Analysis of Amniocentesis in UKMMC

1. Retrospective Analysis of Amniocentesis in UKMMC ZulidaR, MAJamilUniversiti Putra Malaysia, UPM Serdang, Selangor DE and UniversitiKebangsaan Malaysia Medical Centre, JalanYaacobLatif, Bandar TunRazak, 56000 Cheras, Kuala Lumpur,Malaysia. Results Introduction Results: There was no procedural complication and the tissue cell cultures were successful in all cases. The amniocentesis indications were: multiple fetal anomalies detected by obstetric ultrasonography in 44 (68.8 %), high risk in NT screening test 10 (15.6 %), high risk in triple screening test 3 (4.7%), advanced maternal age (≥35 years) in 1 (1.6 %) and other indications in 6 cases (9.4 %). Amniocentesis has been one of the most commonly performed prenatal procedures for cytogenetic analysis 1. It is a prenatal screening and diagnostic test which is considered to be reliable and low risk 2 . However the whole process from the introductory offering and decision-making3 to the disclosure of the results and genetic counselling, may impose high level of anxiety to the patients 4 and family . Thus it is important to understand the indications, karyotype results, complications and outcome of amniocentesis as well as how results of the test are able to contribute to the management of the pregnancy, not only obstetrically but also in relation to the religious belief and request of the patients in order to provide a good support to ease the process. Objectives Conclusions Conclusion: Although the size of this study is small, amniocentesis is found to be a safe and reliable method for chromosomal analysis and an important adjunct to facilitate management of fetal anomalies detected on ultrasound scan. Objective: The aim of this study was to evaluate the indications, karyotype results, complications and outcome of amniocentesis that had been performed in Fetomaternal unit UniversitiKebangsaan Malaysia Medical Centre (UKMMC). Abnormal karyotypes were detected in 17 of 64 cases (26.6 %): three trisomy 13 (1 %), nine trisomy 18 (14.1 %), three trisomy 21 (4.7 %), and two structural chromosomal anomalies (3.2 %). Two-thirds of the fetus with abnormal karyotype were males in trisomy 18 and 13 while the trisomy 21 were all males. All of them were noted to have multiple fetal anomalies on ultrasound. The fetal outcome are shown in Figure 3 and the maternal age in Figure 4. There were 29 cases of fetalanomalies which showed normal karyotype. The outcome are shown in figure 5. Anomalies that required surgical correction post delivery for this group include abdominal wall defect, cleft lip and congenital heart disease(CHD) as in Table 1. All had antenatal referrals done to the respective units and parents were counselled regarding the anticipated problems and possible managements before delivery. Anomalies associated with perinatal death shown in Table 2. References Royal College of Obstetrician and Gynaecologists. Amniocentesis and chorionic villus sampling. Green-top guideline No. 8. London: RCOG Press;2010 [www.rcog.org.uk/womens-health/clinical-guidance/amniocentesis-and-chorionic-villus-sampling-green-top-8]. Grether-González P, Cámara-Polanco V, Kuttothara A, et al. [Prenatal diagnosis by amniocentesis. Clinical and cytogenetic experience in 1,500 cases]. Ginecología Y Obstetricia De México. September 2010;78(9):493-503 Durand M, Stiel M, Boivin J, Elwyn G. Information and decision support needs of parents considering amniocentesis: interviews with pregnant women and health professionals. Health Expectations: An International Journal Of Public Participation In Health Care And Health Policy. June 2010;13(2):125-138 Brajenović-Milić B, MartinacDorcić T, Kuljanić K, Petrović O. Stress and anxiety in relation to amniocentesis: do women who perceive their partners to be more involved in pregnancy feel less stressed and anxious?. Croatian Medical Journal. April 2010;51(2):137-143. Methods Methods: We retrospectively reviewed the case notes and results of 64 amniocentesis cases that were performed in the fetomaternal unit between January 2007 to May 2010 for different indications. The success of cell culture and neonatal outcome were also evaluated. The amniocentesis was performed between 15 to 39 week of gestational age with free hand technique by 22 G spinal needle and 10 ml of amniotic fluid was taken.