Fetal loss rate after second trimester amniocentesis at different gestational age

AbstractObjectivesTo compare the rate of fetal loss in pregnancy after second trimester amniocentesis between procedures performed by experts and non-experts and to assess other pregnancy complications as secondary outcomes.MethodsA retrospective cohort study was performed on singleton pregnancies that underwent mid-trimester amniocenteses in a single institution. The fetal loss rates of procedures performed by experts and non-experts were collected and analyzed. Other adverse pregnancy outcomes were also examined.ResultsIn total, 14,450 amniocenteses were performed during the study period. These included 11,357 (78.6%) procedures in the group expert operators and 3,093 (21.4%) procedures in the group non-expert operators. In the non-expert group, the fetal loss rate was slightly increased but not significantly (p=0.24).In addition, the higher number of spontaneous abortions was associated with blood-stained amniotic fluid sample (p<0.001; RR=9.28). Multiple needle insertions also increased in the non-expert group significantly. However, no difference in pregnancy outcomes was found between in single and multiple needle insertions.ConclusionsThe amniocentesis procedures performed by the non-experts was not increase the fetal loss rate. However, the other adverse pregnancy outcomes, including preterm birth, low birth weight and fetal growth restriction were significantly increased in the non-expert group.

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What is the true fetal loss rate in pregnancies affected by trisomy 21 and how does this influence whether first trimester detection rates are superior to those in the second trimester?

Prenatal Diagnosis ◽

10.1002/pd.134 ◽

2001 ◽

Vol 21 (9) ◽

pp. 788-789 ◽

Cited By ~ 31

Author(s):

Kevin Spencer

Keyword(s):

Trisomy 21 ◽

Loss Rate ◽

Fetal Loss ◽

First Trimester ◽

Second Trimester ◽

Detection Rates

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Revisiting the Fetal Loss Rate After Second-Trimester Genetic Amniocentesis

Obstetrics and Gynecology ◽

10.1097/aog.0b013e318162eb53 ◽

2008 ◽

Vol 111 (3) ◽

pp. 589-595 ◽

Cited By ~ 98

Author(s):

Anthony O. Odibo ◽

Diane L. Gray ◽

Jeffrey M. Dicke ◽

David M. Stamilio ◽

George A. Macones ◽

...

Keyword(s):

Loss Rate ◽

Fetal Loss ◽

Second Trimester ◽

Genetic Amniocentesis

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Transabdominal chorionic villus sampling: Fetal loss rate in relation to maternal and gestational age

Prenatal Diagnosis ◽

10.1002/pd.1970121007 ◽

1992 ◽

Vol 12 (10) ◽

pp. 815-820 ◽

Cited By ~ 12

Author(s):

Giovanni Monni ◽

Rosa M. Ibba ◽

Rosalba Laj ◽

Cau Giuseppina ◽

Mura Silvia ◽

...

Keyword(s):

Gestational Age ◽

Loss Rate ◽

Chorionic Villus ◽

Fetal Loss ◽

Chorionic Villus Sampling

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Selective termination of the fetus in multiple pregnancies using ultrasound-guided radiofrequency ablation

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04285-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nan Li ◽

Jimei Sun ◽

Jiayan Wang ◽

Wei Jian ◽

Jing Lu ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Gestational Age ◽

Loss Rate ◽

Fetal Loss ◽

Perinatal Outcomes ◽

Multiple Pregnancies ◽

Ultrasound Guided ◽

Arterial Perfusion ◽

Before And After ◽

Gestational Age At Delivery

Abstract Background To evaluate the perinatal outcomes in women with selective termination using ultrasound-guided radiofrequency ablation (RFA). Methods Complicated monochorionic (MC) twin pregnancies and multiple pregnancies with an indication for selective termination by ultrasound-guided coagulation of the umbilical cord with RFA under local anesthesia between July 2013 and Jan 2020 were reviewed. We analyzed the indications, gestational age at the time of the procedure, cycles of RFA, duration of the procedure, and perinatal outcome. Results Three hundred and thirteen patients were treated during this period. Seven of whom were lost of follow-up. The remaining 306 cases, including 266 pairs of monochorionic diamniotic (MCDA) twins (86.93%), two pairs of monoamniotic twins (0.65%), 30 dichorionic triamniotic (DCTA) triplets (1%), and three monochorionic triamniotic (MCTA) triplets (0.98%), were analyzed. Indications included twin-to-twin transfusion syndrome (TTTS) (n = 91), selective fetal growth restriction (sFGR) (n = 83), severe discordant structural malformation (n = 78), multifetal pregnancy reduction (MFPR) (n = 78), twin reverse arterial perfusion sequence (TRAPS) (n = 19), and twin anemia-polycythemia sequence (TAPS) (n = 3). Upon comparison of RFA performed before and after 20 weeks, the co-twin loss rate (20.9% vs. 21.5%), the incidence of preterm premature rupture of membranes (PPROM) within 24 h (1.5% vs. 1.2%), and the median gestational age at delivery [35.93 (28–38) weeks vs. 36 (28.54–38.14) weeks] were similar (p > 0.05). Conclusions RFA is a reasonable option when indicated in multiple pregnancies and complicated monochorionic pregnancies. In our experience, the overall survival rate was 78.76% with RFA in selective feticide, and early treatment increases the likelihood of survival for the remaining fetus because the fetal loss rate is similar before and after 20 weeks.

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Risk for fetal loss and prematurity after 12,413 second trimester amniocenteses in a single center

Journal of Perinatal Medicine ◽

10.1515/jpm-2014-0236 ◽

2015 ◽

Vol 43 (3) ◽

Cited By ~ 4

Author(s):

Marianna Theodora ◽

Aris Antsaklis ◽

Konstantinos Blanas ◽

Panagiotis Antsaklis ◽

George Daskalakis ◽

...

Keyword(s):

Loss Rate ◽

Fetal Loss ◽

Invasive Procedure ◽

Controlled Study ◽

Control Group ◽

Study Group ◽

Second Trimester ◽

Second Trimester Screening ◽

Tertiary Center ◽

Significant Difference

AbstractThe purpose of this retrospective controlled study is to estimate the risk for fetal loss and preterm delivery attributed to second trimester amniocentesis from a single tertiary center.The study group consists of 12,413 singleton pregnancies with consecutive amniocenteses, performed in a single tertiary center during a 15-year period (1996–2010) with known pregnancy outcome. The control group consisted of 6993 pregnancies with negative second trimester screening for aneuploidies during the same period who did not have any invasive test. The two groups were compared in terms of fetal loss rate up to 24 weeks and premature deliveries.Total fetal loss up to 24 weeks in the study group, excluding terminations of pregnancy, was estimated at 1.25% (1.05%–1.45%, confidence interval [CI]: 95%). In the control group the loss rate was 0.65% giving a procedure related fetal loss rate of 0.6% which was not found to be a statistically significant difference. Delivery before the 28The present study has shown that the risk of miscarriage that can be attributed to amniocentesis in our institution is 0.6%, and this is not statistically significant when compared with cases without any invasive procedure during pregnancy. Similarly, the risk for preterm labor was not statistically significant when compared with controls.

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Can We reduce Fetal Loss with Second Trimester Miscarriages and very Preterm Births due to Cervical Incompetence in Women with Repeated Failed Vaginal Cerclages and/or Inaccessible Cervices?

International Journal of Infertility & Fetal Medicine ◽

10.5005/jp-journals-10016-1052 ◽

2013 ◽

Vol 4 (1) ◽

pp. 1-5

Author(s):

Sirisha Rao Gundabattula ◽

Lakshmi Rathna Marakani ◽

Shashikala Dasari

Keyword(s):

Gestational Age ◽

Fetal Loss ◽

Preterm Births ◽

Live Birth Rate ◽

First Trimester ◽

Second Trimester ◽

Very Preterm ◽

Cervical Incompetence ◽

Lower Segment Cesarean Section ◽

Preterm Babies

ABSTRACT Objective To assess the reduction in fetal loss following transabdominal cervicoisthmic cerclage done for repeated failed vaginal cerclages and/or inaccessible cervices. Study design An observational study of 113 pregnancies in 90 women after transabdominal cervicoisthmic cerclage from January 1999 to December 2010 at Fernandez Hospital, Hyderabad, Andhra Pradesh, India. Results Mean gestational age at the time of elective transabdominal cervicoisthmic cerclage was 11.6 weeks. Patients were delivered by lower segment cesarean section (LSCS) with a mean gestational age of 36 weeks. Live birth rate was 90.5%. Incidence of mid-trimester miscarriages was 8.6% after cerclage compared with 62.9% before cerclage. Before cerclage, only 13.1% pregnancies continued beyond 28 weeks whereas after cerclage, 88.6% crossed the period of viability. Prior to cerclage, preterm delivery rate was 7.0% (as majority of the pregnancies were lost prior to period of clinical viability) and only 13.6% of these preterm babies survived. Although the incidence of preterm deliveries was 23.8% after cerclage, 80% of these preterm babies survived. Excluding first-trimester miscarriages, fetal loss was 93.3% prior to cerclage and 13.7% postcerclage. In effect, the take home baby rate among pregnancies was only 5.8% before cerclage compared with 86.7% after cerclage. Mean birth weight after cerclage was 2.5 kg. Conclusion Transabdominal cerclage reduces fetal loss and improves pregnancy outcome in women who had failed vaginal cerclages and in those with inaccessible cervices. How to cite this article Marakani LR, Dasari S, Gundabattula SR, Joseph E. Can We reduce Fetal Loss with Second Trimester Miscarriages and very Preterm Births due to Cervical Incompetence in Women with Repeated Failed Vaginal Cerclages and/or Inaccessible Cervices? Int J Infertility Fetal Med 2013;4(1):1-5.

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