Doing amniocentesis yes or no: (A Narrative Review)

Background: Several methods are used in diagnosis of syndromes like trisomy including alpha-fetoprotein (AFP), non-conjugated estriol, human chorionic gonadotropin, inhibin, ultrasound, amniocentesis, chorionic villus sampling in the first half of the pregnancy and PUBS test after 20 weeks into pregnancy in cases of strong clinical suspicion. Since the definitive diagnosis is possible only by chromosome analysis, usage of amniocentesis has been increased nowadays. But, according to reported mortalities and fetal complications of this aggressive action, this question may come to mind that amniocentesis should be done or not Accordingly, this study was performed in order to evaluate the complications of amniocentesis which can lead to a wiser decision.Methods: In this study, we reviewed sources available from webpages of google scholar- PubMed, Science Direct and Cochrane from 2000 to 2016, with keywords such as amniocentesis, trisomy, triple test, quad test, free cell DNA. We’ve used total of 20 papers to perform this study.Result: Our findings show that in case of amniocentesis, fetal mortalities occur from 1% to 1.5%. And from morbidity point of view, there were some reports including unexpected breathing problems, major orthopedic anomalies, heart rate variability and lack of fetal movement for 2 to 3 minutes. Free cell DNA was referred in some papers as a safe test for diagnosis of chromosomal disorders.Conclusion: We propose to replace aggressive amniocentesis test with free cell DNA, as a result of reviewing the papers and the amniocentesis should be done in high risk cases such as cases in which mother is over 35 and father is over 50, history of having children with chromosomal disorders, proven chromosomal disorders in one of the parents and those with positive screening triple test and quad test at week 15 to week 18 of pregnancy.

کلیدواژه ها:

Free Cell DNA ، Quad Test ، Triple test ، Trisomy ، Amniocentesis