Amniocentesis; diagnostic
CPT4 code
Name of the Procedure:
Amniocentesis; also known as Amniotic Fluid Test (AFT).
Summary
Amniocentesis is a medical procedure used to sample amniotic fluid from the uterus. The sample is tested to gather important information about the baby's health, particularly for prenatal diagnosis of genetic and chromosomal conditions.
Purpose
Amniocentesis is performed to diagnose genetic disorders, chromosomal anomalies, and infections in the fetus. It helps in identifying conditions such as Down syndrome, cystic fibrosis, and neural tube defects. The procedure also aids in assessing fetal lung maturity and can help diagnose fetal infections.
Indications
Amniocentesis is typically recommended for:
- Women over the age of 35,
- Those with abnormal results from initial screening tests (e.g., blood tests, ultrasounds),
- Couples with a history of genetic disorders,
- Pregnancies at risk for Rh incompatibility,
- Women with a previous child with a genetic condition.
Preparation
- No specific fasting is required.
- Continue usual medications unless instructed otherwise by your healthcare provider.
- An ultrasound may be performed prior to amniocentesis to locate the position of the fetus and placenta.
Procedure Description
- An ultrasound is performed to locate the baby and the amniotic fluid.
- The skin on the abdomen is cleaned with an antiseptic solution.
- A thin needle is gently inserted through the abdominal wall and uterus to withdraw a small amount of amniotic fluid.
- The sample is then sent to the lab for analysis.
Tools: Ultrasound equipment, antiseptic solution, sterile needle, and syringe. Anesthesia: Local anesthesia may be used to numb the insertion site.
Duration
The procedure typically takes about 20-30 minutes, including the ultrasound and fluid extraction.
Setting
Amniocentesis is usually performed in a hospital or outpatient clinic with facilities for ultrasound imaging.
Personnel
- An obstetrician-gynecologist (OB-GYN) or a maternal-fetal medicine specialist,
- A nurse or medical assistant for support and monitoring.
Risks and Complications
Common risks may include:
- Cramping or mild discomfort.
- Leaking of amniotic fluid.
Rare complications include:
- Miscarriage (1 in 200 to 1 in 400 cases),
- Needle injury to the baby,
- Infection.
Benefits
The primary benefit is accurate diagnostic information regarding the fetus's health, which can aid in early intervention and informed decision-making. Results are typically available within 1-2 weeks.
Recovery
- Patients may experience mild cramping or spotting after the procedure.
- Avoid strenuous activities for 24-48 hours.
- Follow-up appointments may be scheduled to review results and monitor the pregnancy.
Alternatives
- Non-invasive prenatal testing (NIPT): Screens for chromosomal abnormalities using a blood sample from the mother; less risky but not as definitive.
- Chorionic Villus Sampling (CVS): An alternative early diagnostic test; carries similar risks but is performed earlier in pregnancy.
Patient Experience
- The procedure might cause mild to moderate discomfort or a stinging sensation when the needle is inserted.
- Post-procedure cramping and spotting are possible.
- Pain management can include over-the-counter pain relievers such as acetaminophen.
Comfort measures include relaxation techniques and staying hydrated. The healthcare team will provide support throughout the procedure to ensure patient comfort.