Amniocentesis:
by Lauren Feder, M.D.

What is amniocentesis?
Amniocentesis is a medical procedure offered to pregnant women during the second trimester for detection of specific types of birth defects and genetic conditions in the fetus.  The procedure involves an injection of a local anesthetic followed by the insertion of a needle under ultrasound guidance into the uterus through the belly. A sample of amniotic fluid is taken and sent to the laboratory for analysis. 
The test is performed during the 15th and 18th week of pregnancy.  Amnios are most commonly performed on women who have had an abnormal ultrasound, family history of genetic conditions or birth defects, and women who are 35 years or older.  Following the procedure, women are prescribed acetaminophen to relieve discomfort and cramping. Women are encouraged to rest at home avoiding any strenuous activities, lifting, and sex.  Normal activities can be resumed usually a few days thereafter.

Reasons to consider amniocentesis:
•Detect the presence of Down’s syndrome, sickle cell disease, cystic fibrosis, muscular dystrophy, and such diseases as Tay-Sachs.
•Check baby’s gender. 

Risks of amniocentesis
•Although there are risks to any invasive procedure, it is not considered high risk
•Complications from the procedure are rare they include: bleeding, miscarriage (<1%), clubfoot, preterm labor, respiratory illnesses in babies at birth, and infection or injury for baby or mother.
•As with any invasive procedure, the test can be uncomfortable. 
•May require more than one needle insertion, due to movement of the baby, poor position, or even a Braxton-Hick contraction of the uterus.
•Cause for worry as it takes two to three weeks to receive the results of the test. 

Considerations
We live in an era of sophisticated technological advances in modern obstetrics. Amnios provide us with a lot of information about our unborn child including whether the baby may have Down’s syndrome or  serious  fatal  condition. Women who receive a positive test are counseled regarding genetics and presented with options, including termination of pregnancy.  Although we may not know how we would respond if we were to receive information of this nature, I encourage expectant parents to consider the implications of an amniocentesis beforehand.  An amnio is an elective test, not a routine one, even if you are 35 years or older.  In weighing out the risks and benefits of an amnio, women who would not consider termination of pregnancy, usually do not have this procedure.
 
If you are having an amniocentesis consider the following:
General Home Treatment
•Be well rested prior to the procedure.  Avoid overexerting yourself either before or after the procedure, until completely healed.
•Rest after the procedure. Although most women recover after several days, resume normal activities gradually.  Listen to your body.
•Eat well and drink increased amounts of healthy fluids. 
•Hot water bottle as needed for cramps.
•Homeopathy
     Gelsemium 30C for anxiety and anticipation. (3 pellets twice a day before or after procedure as needed).
     Arnica montana 30C for bruising and soreness (3 pellets twice a day for 2 days following procedure). 
     Ledum palustre 30C for the puncture wound (3 pellets twice a day for 2 days following procedure).