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Amniocentesis

By

Megan Freedman

What is amniocentesis?

Amniocentesis is a test performed during pregnancy to diagnose genetic disorders, chromosomal abnormalities, and birth defects. It can also help diagnose certain infections and the maturity of your baby’s lungs. 

Amniocentesis involves inserting a needle through the abdomen to take out a small amount of amniotic fluid from inside the uterus. Amniotic fluid is the liquid that surrounds the growing fetus. The amniotic fluid sample is tested in a laboratory. 

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An amniocentesis is only one method used to test for conditions of a fetus. You may have less invasive testing options. Discuss all of your testing options with your doctor or healthcare provider to understand which options are right for you.

Why is amniocentesis performed? 

Your doctor may recommend an amniocentesis to diagnose certain diseases and conditions of the fetus including:

  • Anencephaly, a serious birth defect in which a large part of the brain and skull are not formed

  • Cystic fibrosis, a genetic disease in which the body makes too much mucus and sweat

  • Down syndrome and other conditions caused by chromosomal abnormalities

  • Infections of the uterus or the baby

  • Need for early delivery. Your doctor may perform an amniocentesis when considering inducing early labor. Early labor and delivery protects the health of the mother or baby in some cases. Testing the amniotic fluid helps determine if the baby’s lungs are developed enough for birth.

  • Rh incompatibility of the mother and baby. This is a condition in which the mother has Rh-negative blood and her baby has Rh-positive blood. This can cause a reaction that breaks down the infant’s red blood cells. The reaction can be mild to serious and cause yellow skin and eyes (jaundice), lethargy, and low muscle tone.

  • Spina bifida and other serious neural tube defects caused by incomplete closure of the spine during fetal development 

Doctors also perform amniocentesis to drain extra amniotic fluid in rare cases. Too much amniotic fluid (polyhydramnios) increases the risk of premature labor and delivery and other serious problems.

Ask your doctor about all of your testing and treatment options and consider getting a second opinion before deciding on amniocentesis. 

Who performs amniocentesis?

An obstetrician-gynecologist or perinatologist performs amniocentesis. An obstetrician-gynecologist specializes in the health needs of adolescent and adult women, including pregnancy and labor and delivery. A perinatologist, also called a maternal-fetal medicine specialist, is a doctor who specializes in high-risk pregnancies.

How is amniocentesis performed?

Amniocentesis is most often performed between 15 and 20 weeks of pregnancy (during the second trimester). It is performed later to test for infection and your baby’s lung development.

Your amniocentesis will be performed in a doctor’s office or outpatient hospital clinic. It takes about an hour and generally includes these steps:

  1. You dress in a patient gown from the waist up.

  2. You lie on your back on a procedure table. Your doctor may move or tilt the table during your exam.

  3. Your doctor puts ultrasound gel on your abdomen. The gel helps the ultrasound equipment make full contact with your skin by eliminating air. It also allows the equipment to slide easily across your skin without discomfort.

  4. Your doctor places an ultrasound transducer on your skin. The transducer is a handheld wand that sends and receives sound waves. The doctor presses it firmly onto your skin and moves it around to see your uterus and fetus. The transducer and sound waves are painless.

  5. Your doctor uses the ultrasound images to guide needle insertion. Your doctor will push the needle through your abdomen until it enters the uterus.

  6. Your doctor removes about an ounce of amniotic fluid and withdraws the needle. 

  7. Your doctor may perform more ultrasound imaging see how the fetus is developing.

  8. Your doctor wipes off the gel. The gel is water-based and washes away easily.

  9. You may wait a short period while your doctor verifies that the ultrasound imaging is complete. Women usually go home right after the exam.

  10. A laboratory tests your amniotic fluid. You will get the results in about two weeks.

Will I feel pain?

Your comfort and relaxation is important to you and your care team. An amniocentesis may involve minor pain when the needle enters your abdomen and uterus. You may feel minor pressure on your abdomen from the ultrasound transducer. You may feel some cramping during and after fluid withdrawal. 

Take a few long, deep breaths to help yourself relax. Tell your doctor if any discomfort does not pass quickly.

What are the risks and potential complications of amniocentesis? 

Amniocentesis involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during or after the procedure and include:

  • Amniotic fluid leakage
  • Cramping 
  • Miscarriage (rare)
  • Infection that enters from outside the uterus through the needle
  • Needle injury to the fetus (rare)
  • Vaginal bleeding

How do I prepare for amniocentesis?

You are an important member of your own healthcare team. The steps you take before amniocentesis can improve your comfort and outcome.  You may need to drink extra fluids to fill your bladder before the test. This is important to have clear ultrasound images to guide the needle safely into the uterus.

Remember that amniocentesis is a safe test for most women. This test can cause some anxiety about the state of your pregnancy, so you may want to have someone come with you. 

Questions to ask your doctor

Facing an amniocentesis can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before amniocentesis and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Common questions include:

  • Why do I need an amniocentesis? Are there any other options for diagnosing fetal conditions?

  • How long will the procedure take? When can I go home?

  • When and how will I receive the results of my test?

  • What other tests or treatments might I need?

  • When should I follow-up with you?

  • How should I contact you? Ask for numbers to call during and after regular office hours.

What can I expect after amniocentesis?

Knowing what to expect after an amniocentesis can help you get back to your everyday life as soon as possible.

How will I feel after an amniocentesis?

Amniocentesis may cause some pain or discomfort during the procedure. Any discomfort should go away quickly after the test. Call your doctor if you have pain or discomfort after the procedure. 

Your doctor may recommend that you rest for the remainder of the day. Women generally return to normal activities by the morning after amniocentesis.

When can I go home?

Women usually go home right away after amniocentesis.

When should I call my doctor?

It is important to keep your follow-up appointments after amniocentesis. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Cramps lasting longer than a few hours
  • Excessive or ongoing vaginal fluid loss (more than a few tablespoons) 
  • Fever 
  • Vaginal bleeding
Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 13, 2016

© 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Amniocentesis. American Pregnancy Association. http://www.americanpregnancy.org/prenataltesting/amniocentesis.html
  2. Amniocentesis. March of Dimes. http://www.marchofdimes.com/pregnancy/prenatalcare_amniocentesis.html
  3. Facts about Anencephaly. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/birthdefects/anencephaly.html
  4. Screening for Birth Defects. The American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq165.pdf?dmc=1&ts=20130414T1508160672

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