Objective To compare pregnancy complications in women having genetic amniocentesis at 11–14 weeks versus those undergoing amniocentesis at 16–19 weeks gestation.
Methods A genetics data base was used to identify patients retrospectively, those who had genetic amniocenteses by three experienced operators during a 4-year period. The study group consisted of women who had amniocenteses at 11–14 weeks' gestation. For each study patient (early amniocentesis), two controls (amniocentesis at 16–19 weeks) were identified and matched for maternal age, race, and the number of prior spontaneous abortions. An immediate postprocedure complication was defined as any vaginal bleeding, rupture of membranes, or fetal loss occurring up to 30 days after the amniocentesis. A later complication was defined as any fetal death longer than 30 days after the amniocentesis, any preterm delivery, any infant weighing less than the tenth percentile for gestational age, and any neonatal death. Immediate and later complications were compared between the study and control groups.
Results The study group consisted of 314 patients who were matched to 628 controls. Women who had a genetic amniocentesis performed at 11–14 weeks were significantly more likely to have post-procedure amniotic fluid leakage (2.9 versus 0.2%), post-procedure vaginal bleeding (1.9 versus 0.2%), and a fetal loss within 30 days of the amniocentesis (2.2 versus 0.2%) than women undergoing genetic amniocentesis at 16–19 weeks' gestation. Four of the seven patients (57%) with a fetal loss within 30 days of an early amniocentesis had procedure-related complications, such as amniotic fluid leakage, bleeding, and infection, that caused the pregnancy to be lost. No differences were noted between the two groups in the number of preterm deliveries, later fetal deaths, neonatal deaths, or newborns weighing less than the tenth percentile for gestational age.
Conclusion Genetic amniocentesis at 11–14 weeks is associated with more post-procedure complications and a higher fetal loss rate within 30 days of the procedure than a genetic amniocentesis performed at 16–19 weeks' gestation.
Address reprint requests to: Cynthia G. Brumfield, MD, 618 South 20th Street, Old Hillman Building, Room 450, Birmingham, AL 35233-7333.
© 1996 The American College of Obstetricians and Gynecologists