What is the purpose of an amniocentesis?

[Duer 157099]

When I was pregnant, having an amnio was an option, not a routine screen. And the ONLY purpose was to detect genetic abnormalities so that a decision could be made about whether to continue the pregnancy.

Is there any other valid reason to have one done?

This isn't about who's child this is -- this is very pointedly about the issue of abortion and choice and potential hypocrisy.

I'd like to hear from any ob-gyns who can answer this: if you have a patient who is militantly opposed to abortion, are amnios performed on them anyway? Why?

[moriah]

1. Again....

"There are three purposes of prenatal diagnosis: (1) to enable timely medical or surgical treatment of a condition before or after birth, (2) to give the parents the chance to abort a fetus with the diagnosed condition, and (3) to give parents the chance to "prepare" for a baby with a health problem or disability, or for the likelihood of a stillbirth.

Having this information in advance of the birth means that healthcare staff can better prepare themselves (have suitable treatment ready ) and parents (providing counselling) for the delivery of a child with a health problem."

Even if the number 2 reason doesn't apply, number 1 and 3 likely would.

[Duer 157099]

2. Yeah, I just saw your post in the other thread

Given the whole water-breaking (or whatever) and the flight back to Alaska, and the drive to the hospital in the boonies... I'm going to say that these people were not really the "err on the side of caution" types.

I'm calling bullshit big time.

[madeline_con]

5. Thanks for that.

Did Palin think there might be health problems, and if so, why?

What's with the big surprise issue? No one knew, not even her staff? There was mention of the crew on the plane being unawre she was pregnant. This is a woman who's supposedly in labor.

Were all the other kids a big secret?

[curious one]

6. I am with you on this BS. Either we are dealing with a super woman or Alaskan are gullible to

accept this. This woman reminds me of another one who keeps telling lies and getting away with it.

[FedUpWithIt All]

3. I had an amnio at 37 weeks to determine if my baby had lung maturity to be induced.

i had insulin dependent diabetes.

[Duer 157099]

7. OK, valid reason.

But I don't think this applied to the Palins.

There are, of course, so many exceptions, but I think we all know that the vast majority of the times, the sole purpose is to aid in deciding on whether to continue the pregnancy.

[MichaelHarris]

4. fetal lung maturity

lecithin/sphingomyelin (L/S) ratio, did about brazillion when I worked at the University of Texas Medical Branch. Used to be sort of routine with patient with previous C-sections.

[madeline_con]

8. As a precursor for early induction of labor?

If so, what are some of the reasons for early induction?

[MichaelHarris]

12. not necessarily

more of a precaution for those who had had previous C-sections. Now it could be used to decide when to induce labor if the fetuses lungs are mature. Now-a-days they do some genetic testing using amniotic fluid but it's mostly drawn for fetal lung maturity.

Some reasons are: prevention respiratory distress syndrome (RDS) in early delivery Amniotic fluid test for fetal maturity; indicator to determine optimal time for obstetrical intervention in cases of possible fetal distress: maternal diabetes, toxemia, hemolytic disease of the newborn (erythroblastosis fetalis), postmaturity.

[madeline_con]

16. Thank you.

[Duer 157099]

9. So then let me ask you:

did you do a chromosome smear too at the same time, just because you could? I wonder how much the patient/insurance gets billed for this extra test, and whether it's optional?

[MichaelHarris]

14. no, no, no

It was never done unless the patient wanted it and only then after discussion with the Ob/Gyn. Are patients tended to be very poor so it was never really done, no one with money goes to UTMB. It's an expensive test, the genetic one. There would have to be precursors to even consider the genetic testing avenue.

[lligrd]

10. The Risk Of The Procedure Alone Kept Me From Getting It Done

and I am pro-choice. I have no idea why someone who would not consider abortion would risk it.

[Duer 157099]

11. Hello?!!! Thank you!!!

Exactly! My doc had me scared out of my wits just thinking about having it done!! It's not like a little finger prick.

[SoCalDem]

13. I was scheduled for one, but it didn't matter in the end

whether his lungs were mature enough, because that night I had an abruption (30-40%) and had an emergency Csection.. I have always been glad I did not have the amnio, or I would have always thought it might have caused the abruption..

[MichaelHarris]

15. The risk of an amnio?

It's very easy and almost without risk, first and second year residents can do it. A person would have to be a total hack to mess one up.

[lligrd]

17. It Is Done Late In The Pregnancy And

any risk at that point was too great for me to consider. What pray tell would one learn, especially if you were totally against abortion?

[madeline_con]

18. Maybe the baby's ethnicity.

If an anti-choice white couple planned on passing said baby off as their own, the daughetre giving birth to a brown or black baby wouldn't work.

[moriah]

20. All right, you've said this too many times, and I'll bite here.

If all of this tinfoil-hattery is actually true...

Wouldn't it have been much, much easier to only have to have the mono excuse, take her out of school, and give the baby up for ADOPTION without trying to fake a pregnancy?

No concerns about supposed ethnicities of the child to worry about, no one would question whether she could balance being a chief executive of a state or vice-president of the United States and still raise a newborn, no need to pad your belly or whatever else a person would have to do to pretend they were pregnant instead of their daughter, and since the law protects the confidentiality of adoptive mothers there would be a lot less risk of getting caught out by anyone???

I don't watch Desperate Housewives, but I did read a VC Andrews book called Garden of Shadows, and I thought even it was pretty damn farfetched.

[lligrd]

24. Self Delete

[madeline_con]

25. Maybe Palin didn't want to give her grandchild up.

I can understand that.

[MichaelHarris]

19. if it's for fetal lung maturity

then it's always done late. They use ultrasound when it's done so the fetus doesn't get poked. Rarely some women had very low amniotic fluid volumes or small sacs that made it tricky but with ultrasound it was pretty safe. I didn't follow the reason the OQ was asked but in response to your question, if someone was totally opposed to abortion and was getting an amnio for genetics then that seems to be a waste of money. Getting it late term makes it even more stupid.

If the amnio was done solely for fetal lung tests then it makes more sense if she was in premature labor or she had one or more previous C-sections. Bottom line, if the amnio was drawn late term and was said to be for genetics testing then you have a wasteful patient and a stupid doctor. That information should have been gathered earlier in the pregnancy.

[janx]

23. Amnio can determine a lot.

The growth of the baby, possible abnormalities, all kinds of things. For women who have C-sections, amnio is routine.

[LeftishBrit]

21. While some doctors won't perform amnios if you are definitely not going to terminate..

(because they carry a small risk of miscarriage), neverthless some do if asked, and some mothers prefer to know of any abnormality so as to be prepared in advance, even if they would keep the baby.

Also: some mothers will terminate for some conditions but not others. There are some chromosomal disorders that are rarer and more severe than Downs - but also commoner in older than younger mothers - and which are usually fatal in infancy (e.g. trisomy 13). There are some mothers who would terminate for a fatal condition, but not for a disabling but non-fatal condition like Downs. Of course, the person being discussed here has claimed to oppose ALL abortions, but nontheless this could be an issue in reality.

[Meshuga]

22. It is highly recommended if you are over 35

At least it was when my wife was pregnant because the chances of down syndrome increases exponentially for pregnant women 35 and over.

[mnhtnbb]

26. Amniocentesis does carry risk. The uterine wall is pierced in order to obtain

the amniotic fluid. There is some risk that the uterine wall will not close and that amniotic
fluid may begin leaking. This can lead to infection and ultimately early labor.

I had early complications at 12 weeks with my second pregnancy when I thought I'd lost the baby.
Because of my age I had an amnio, done by a specialist not my attending OB (which I also had with my first pregnancy at age 35). Everything was fine. Then at 22 weeks my membranes ruptured and I delivered our stillborn daughter.

My OB (an anti-choice Baptist in MO)was sure the amnio was the cause of the early rupture of membranes. When I called the specialist, he was furious that the OB would suggest it.

I eventually came to believe that I had been pregnant with twins, had lost one twin at 12 weeks, and didn't know why my membranes ruptured at 22 weeks.

Then I became pregnant again at 38. We decided not to do an amnio (and believe me hubby was scared stiff of the odds of Downs, but I just had a feeling it was ok). Then around 17 weeks I had a feeling
something wasn't right. I went to my regular OB who discovered I had already started dilating.
He stitched me up (closed the cervix)and put me on bed rest from 17 to 36 weeks. That gave
us the answer as to the probable reason I had lost our daughter--which is called incompetent cervix.
It wasn't related to the amnio at all.

My point, though, is that there is risk with amniocentesis. Unless one is prepared to take
action, there's no point in having it done.

[pizoxuat]

27. You start with an AFP or a triple screen

http://pregnancy.about.com/cs/afp/a/afptesting.htm

I'm pregnant right now. At 12 weeks you can get an AFP done. All they do is take the mother's blood in a regular blood draw, there is no risk to the baby at all. At 16 weeks you can have the pentascreen. It's also a regular blood draw. If either of these tests show a risk of Down Syndrome, you can get a detailed fetal anatomy ultrasound and an amniocentesis done to confirm the diagnosis.

I did the pentascreen for peace of mind. It was $200 and was covered by insurance. Almost all the women I know who are currently pregnant have had either the AFB or the pentascreen or both.