Amniocentesis Procedure
Amniocentesis Procedure
SATTUR, DHARWAD.
[A Constitute Unit of Shri Dharmasthala Manjunatheshwara University]
Sattur, Dharwad.
AMNIOCENTHESIS
IDENTIFICATION DATA:-
Name of the Client :- Mrs. Saraswati
Age :- 26 years
Ward :- OPD
Religion :- Hindu
Procedure :- Amniocenthesis
INTRODUCTION
First perform in1950
Contain amniocytes, and fetal cell from skin, GU system, gut and biochemical products
Most widely used prenatal diagnostic invasive procedure
Every genetic condition diagnosis able through fetal tissue has been made in amniotic
fluid
DEFINITION
It is a diagnostic procedure for aspiration of amniotic fluid by insertion of a needle into amniotic
cavity.
OR
Amniocentesis involves the aspiration of amniotic fluid from the amniotic sac via a 20 gauze
spinal needle inserted through maternal abdomen. It is usually performed between 15-18 weeks
gestation under ultrasound guidance.
DIAGNOSTIC INDICATION:-
A) Diagnosis of genetic disorders-
i. Women with positive serum screening for Down’s syndrome.
ii. Women of advanced maternal age (Traditionally > 35yrs.)
iii. Ultrasound detection of an abnormality soft tissue markers.
iv. Parental balanced translocation.
v. A previous history of chromosomal abnormality.
Therapeutic Indications
1) To venous amniotic fluid in polyhydramnios & in twin transfusion syndrome (TTTS)
2) Amnioinfusion in Oligohydramnios.
3) Inj. Of drugs for reduction of fetal no. in 4 or more fetuses.
4) Fetal blood transfusion in severe anemia.
5) Drug therapy.
COMPLICATIONS:-
Amniocentesis is a state procedure when performed by an experienced obstetrician under
ultrasonic guidance. Some of the complications which can develop occasionally are;
i. Chorioamnitis
ii. Miscarriage rate 1 in 300 to 1 in 500
iii. Leakage of Amniotic fluid occurs in about 2% patient’s.
iv. Fetal trauma like stain climping, fistula, cord hematoma equinovarus.
v. Vaginal bleeding
vi. Rh-isoimmunization.
vii. Preterm labour.
viii. Respiratory distress
ix. Intrauterine death (IUD).
CONTRAINDICATIONS:-
1) Abdominal wall sepsis.
2) Anterior attachment of placenta (relative).
PRE-REQUISITIES:-
Informed consent
Anti-D for Rhstatus of patient (if Rh negative, give 150mg of injection Anti-D post
procedure in a none sensitized patient).
Ultrasonography-localization of placenta and site of puncture
A 20-22 gauge spinal needle.
Container-for amniotic fluid collection.
1% lignocaine
Benzoin seal or band
PROCEDURE:-
SL. NO. PROCEDURE RATIONALE
1. Keep bladder empty Appearance of clear or amber colored
fluid on withdrawing the stylet
indicates that the needle is the
amniotic cavity.
2. Place patient in supine position with a 150 Stop the procedure if frank blood is
tilt. obtained, the needle is probably in the
placenta.
3. Under ultrasound guidance the placenta is
being localized and determines the site of
puncture.
4. Locate the site of puncture:
Usually opposite to the back between fetal
limbs or in the triangular space between
head and shoulders
5. Abdominal parts are painted and draped.
6. Infiltrate with 1% lignocaine at the site of
puncture.
Using a 140cm long 18 gauge needle having
Luer lock and stylet, puncture the
abdominal wall and myometrium; needle is
passed at right angles to abdominal skin.
7. Collect up to 10 ml of amniotic fluid if done
for diagnostic purposes.
8. If therapeutic amniocentesis is done: Hub of
the needle is connected by tubing with C
clip attached to a collection chamber, which
should be at a lower level than the patient.
9. Drain slowly (not > 500/hour) till patient is
relieved of her pressure symptoms;
approximately 1-1.5L is removed.
10. After aspiration/drainage, reintroduce the
stylet and withdraw the needle and stylet
quickly.
11. Apply tincture Benzoin seal or Band-Aid at
the site of puncture.
12. Observe the patient over next few hours for
complications.
POST-PROCEDURE TREATMENT:-
Administer prophylactic antibiotics and analgesics.
Monitor vital signs and FHS every 15 minutes for two hours.
Monitor for bleeding/leaking PV, abdominal pain, fever/chills.
Hemorrhage
Infection (Chorioamnionitis)
Fetomaternal hemorrhage
Premature rupture of membranes (PROM)
Preterm labor
Fetal Complications:-
DISCHARGE TEACHING:-
Teach patient to report if:-
BIBLIOGRAPHY:-
Swain Dharitri. Obstetrics nursing procedure manual. Jaypee the health sciences
publisher:New Delhi;2017. Pg.No. 134-136.
Jacob Annamma, R Rekha. Clinical nursing procedures: The art of nursing practice. 2 nd edition.
Jaypee publisher: New Delhi; 2010.Pg. No. 112-117.