To Amnio or Not to Amnio by Rebecca Garland

Amniocentesis is a word pregnant mothers aren’t anxious to hear. It’s one of the more controversial tests during pregnancy that some mothers anxiously wait for and others flat out refuse. The rational of each mother differs by her personality as well as by each of her pregnancies. When it comes to the amnio, there is no right or wrong answer.

Amniocentesis
Amniocentesis and its cousin Chorionic villus sampling (CVS) are both tests which involve taking a sample of material from inside the womb and running tests to check for any genetic or chromosomal abnormalities in the fetus. CVS is performed between 10-13 weeks of pregnancy and involves taking a sample from the placenta for testing. Amniocentesis, or an amnio as many call it for short, is done closer to 15-18 weeks and takes a sample of amniotic fluid for testing.

Both procedures involve a long needle entering the uterus through the mother’s abdomen. The needle pierces the skin and travels into the uterine environment – an environment that is usually completely sealed off from the outside world. The penetration and disruption of this environment is why many mothers feel either procedure is too risky. Others feel the risks of the test are justified by the knowledge they gain.

Risks and Benefits of Testing
With testing equipment passing through the amniotic fluids, the needle, a foreign body,

can cause infection in the uterus. This is extremely dangerous to the baby and mother. The procedure also has a 1 in 200 chance of causing miscarriage although new tests are showing that risk as less, perhaps 1 in 1,600. Puncturing the normally sealed bag of waters also has the possibility to cause a leak in fluid. If fluid is leaking and not detected, the baby can be born with lung problems or other complications.

Women are willing to take these risks however, because no tests to date are more effective at determining the presence of genetic or chromosomal disease. If such as disease is present, parents may have the option to terminate the pregnancy if complications are greater than the baby’s chance at life. Other parents would never abort a despite the severity of a problem, but appreciate the extra time to prepare themselves and their families for a child with special needs or a child with a very short anticipated lifespan.

While these tests can’t catch every problem, in the majority of cases they reassure parents that there are no genetic or chromosomal problems evident with their babies, and for parents who are carriers of such conditions, this can be a huge relief. Amnio is also used near the end of complicated pregnancies to check lung maturity in premature babies who need to be delivered early. Once lungs are mature, the baby needs much less support on the outside of the womb. A side benefit of testing early in the pregnancy is parents will know with certainty the gender of their baby weeks before it is discernable on ultrasound.

Recommended Tests
The whole of the pregnant population is not required or requested to take this test. In fact, pregnant mothers who are asked to take these tests often opt out as they do not want to risk even the slightest harm their babies and feel sure the results won’t influence their pregnancy decisions anyway.

As it stands, some mothers are strongly encouraged to test:

• Mothers over 35 as age is a high factor for increased abnormalities
• Mothers with abnormal blood screen results
• Mothers with abnormal ultrasound findings
• Mothers with a family history of chromosomal and genetic problems
• Mothers of a baby with a parent who is a carrier for a disease
  

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