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After 21 weeks, Amniocentesis still 'fairly safe'. (Rate of Nonlethal Complications was 3%).

NEW YORK -- Amniocenteses performed after 21 weeks' gestation caused nonlethal complications in 3% of 365 procedures, but other invasive prenatal procedures done after 21 weeks were riskier, Dr. Alain Gagnon reported.

The findings came from a retrospective review of 375 charts for pregnant women who underwent 512 prenatal invasive diagnostic or therapeutic procedures after 21 weeks' gestation over a 4-year period. Amniocentesis this late in pregnancy "appears to be fairly safe, with a rate of complications very similar to what is reported for midtrimester amniocentesis: around 1 in 166," he said at the 12th World Congress on Ultrasound in obstetrics and Gynecology.

Before conducting this study, Dr. Gagnon of the University of British Columbia, Vancouver, and his associates found only one published study of prenatal invasive procedures performed after 20 weeks. That study showed a slight decrease in complications with cordocentesis performed after 22 weeks' gestation rather than earlier.

In the current study, 10 fetuses (3%) in the amniocentesis group died in utero an average of 39 days after the procedure. The numbers include not only intrauterine demise attributed to the procedure but also deaths caused by fetal pathology Four of the deaths occurred within 4 weeks of the amniocentesis, when complications from the procedure might be expected to appear, he said.

Excluding intrauterine deaths, 11 other complications after amniocentesis occurred at 36 weeks' gestation on average.

Only 1 woman in a subset of 166 who underwent amniocentesis before 34 weeks' gestation developed a complication before 34 weeks, the time when physicians start to consider using steroids to reduce neonatal complications, he added.

Besides amniocentesis, one other invasive procedure seemed relatively safe: intrauterine transfusion, with a complication in 1 of 33 cases.

"For most other prenatal procedures, the risk is more significant. That certainly should be taken into consideration when counseling" patients, Dr. Gagnon said at the meeting, also sponsored by the International Society of Ultrasound in Obstetrics and Gynecology.
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Author:Boschert, Sherry
Publication:OB GYN News
Date:Jan 15, 2003
Words:320
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