Amniocentesis: the why, how, when, where, risks (side effects), benefits and cost
Amniocentesis is one of the numerous but popular form of prenatal diagnosis of inherited diseases and therapy. It is the simplest invasive technique, which in the past 30 years has become the routine method to exclude chromosomal and metabolic disorders of the fetus.
When is it done ?
It is most commonly performed at 15 – 18 weeks of gestation during your pregnancy. Results will be available within 5 days.
Why is it done? The Benefits
Amniocentesis is very much beneficial in prenatal diagnosis and screening, that is, diagnosing and screening your unborn baby of any diseases or congenital defects before birth.
Amniocentesis is used for karyotypying (knowing fetal sex), diagnosing metabolic disorders, diagnosing single gene disorders like sickle cell anemia and cystic fibrosis before birth, screening for neural tube defects (alpha fetoprotein and acetycholinesterase level), and bilirubin level for Rhesus incompatibility and hemolytic diseases of the newborn. It is used to detect diseases like spina bifida, Trisomies like Down Syndrome, Patau Syndrome and Edward Syndrome. It is also used for prenatal DNA paternity testing.
Procedure, how is it done?
It is done in the theatre under ultrasound guidance. An aseptic technique is used. You will wear gowns and drapes. A sample called amniotic fluid will be collected from the bag containing the baby called the amniotic sachets by a trained gynaecologist. Sample is there after sent to the lab for analysis and testing. Both supernatant and fetal samples are collected. You will be given adequate painkillers and antibiotics before and after the procedure.
It is safe. The overall rate of fetal losses possibly caused by the procedure was found National and single centre studies to be 1 percent or less with possible higher risk in twin pregnancies. If proper precautions are taken the risk of maternal contamination is very low. Potential risk include the requirement to withdraw a proportionately larger volume of amniotic fluid, bleeding, damage to the yolk sac, injury to the baby and sometimes difficulty in sample analysis. Removing too much fluid may result in fetal lung problem.
Amniocentesis is associated with 0.5 percent rate of miscarriage. However, in the Lagos ( Nigeria) amniocentesis programme, more than 300 procedures have been performed without complications.
After the procedure, you may experience cramping, leakage and minor irritation around the puncture site.
The truth is with skilled hands, the procedure has very minimal risks.
Where can amniocentesis be done?
In Nigeria, amniocentesis is done in federal teaching hospitals, some state teaching hospitals (LASUTH), and some private fertility and IVF clinics.
In Lagos, amniocentesis can be done in Lagos University Teaching Hospital (LUTH), LASUTH, and some fertility clinics like Bridge clinic, Omvi, Nordica, high rocks fetal medicine and diagnostic centre lekki, Nordica, Trucare and many others here.
In Benin, it can be done at UBTH, Graceland Medical Centre, St. Augustine Medical Center, Lily and others here.
In Port Harcourt, it can be done in UPTH, Nisa prime, Gynescope, Bridge, Care Women and others here
In Abuja, National Hospital, Nisa Prime, Nordica, Bridge Clinic and other fertility centres do amniocentesis.
In Kano, you can have prenatal diagnosis done at Aminu Kano Teaching Hospital
In Ibadan, University College Hospital (UCH) and other private fertility centres do amniocentesis.
In Eastern Nigeria, check for the procedure at UNTH in Enugu, NAUTH in Anambra, and Federal Medical Centre, Owerri and FMC Umuahia. Some fertility centres bases in South Eastern Nigeria also performs the procedure.
Cost of Amniocentesis
This what you want to see I know. Amniocentesis is not a cheap procedure but it is affordable. I know of a woman who had amniocentesis in one of the private fertility clinics in Lagos for #300, 000 Naira. Some fertility centres in Lagos Island charge as high as #500,000 naira for amniocentesis. Most teaching hospitals and Federal Medical Centres perform the procedure for between #180,000 to #200,000 Naira. It could be less.
The drawbacks of this procedure include: the need to obtain cultured amniotic fluid cells for cytogenic and most DNA and biochemical studies, as well as the procedure’s availability only in the second trimester of pregnancy. Termination of pregnancy in the in the second trimester of pregnancy after diagnosis of a severe fetal disease may inflict considerable medical risks and emotional burden on the woman.
Featured image credit: Baby centre