During pregnancy, the fetus is surrounded by amniotic fluid, a substance much like water. Amniotic fluid contains live fetal cells and other substances, such as alpha-fetoprotein (AFP). These substances provide important information about your baby’s health before birth.
What Is Amniocentesis?
Amniocentesis is a prenatal test in which a small amount of amniotic fluid is removed from the sac surrounding the fetus for testing. The sample of amniotic fluid (less than one ounce) is removed through a fine needle inserted into the uterus through the abdomen, under ultrasound guidance.
The procedure takes only a couple of minutes, the fluid is then sent to a laboratory for analysis. An ultrasound is used as a guide to determine a safe location for the needle to enter the amniotic sac, so the fluid may be safely removed. The baby reform the amniotic fluid, fetal wellbeing confirmed routinely following the procedure.
Because amniocentesis presents a small risk for both the mother and her baby, the prenatal test is generally offered to women who have a significant risk for genetic diseases, including those who:
- Have an abnormal ultrasound or abnormal lab screens
- Have a family history of certain birth defects
- Have previously had a child or pregnancy with a birth defect
- Had an abnormal genetic test result in the current pregnancy
What to expect after the procedure?
The majority of women have no adverse effects but you may experience some cramps in the lower abdomen resembling menstrual pains and sometimes vaginal spotting. You may receive paracetamol for pain relief.
When you will get the test results?
For major anomalies like Down’s syndrome the results will be available in three days from the test but the minor anomalies take longer time which may extend to 3 weeks.
You will receive a phone call from dr Wael’s center to schedule a meeting with the parents to discuss the test results.
What is the adverse effect of the procedure?
- 0.1% of women may experience miscarriage within the first 5 days following the procedure, if you had miscarriage after that this won’t be related to the procedure or the CVS which is obtaining a bite from the placental tissue.
In 1% of cases you may need to repeat the test when the results are inconclusive.
What is Cell free fetal DNA testing?
It is the new era in prenatal testing for fetal anomalies through maternal blood as it contains the fetal DNA (fetal genetic material), a blood sample will be obtained and sent to USA for testing. The results usually will be available within 2 weeks and you will receive a call from our centre to schedule an appointment for discussing the results with dr Wael
Chorionic villus sampling (CVS)
Is a prenatal test that is used to detect birth defects, genetic diseases, and other problems during pregnancy.
You may be offered CVS if you have certain risk factors for having a baby with a birth defect or genetic disease, so that problems can be found early in pregnancy.
How it is performed?
During the test, a small sample of cells (called chorionic villi) is taken from the placenta where it attaches to the wall of the uterus through applying local anesthesia over your abdomen. The time needed for this procedure is about a couple of minutes. Chorionic villi are tiny parts of the placenta that are formed from the fertilized egg, so they have the same genes as the baby.
When CVS is performed?
We do the test at the 11th week of pregnancy as the most recent studies showed that if it’s performed earlier will lead to anomalies in fetal toes and fingers.
What to expect after the procedure?
The majority of women have no adverse effects but you may experience some cramps in the lower abdomen resembling menstrual pains and sometimes vaginal spotting. You may receive paracetamol for pain relief.
When you will get the test results?
For major anomalies like Down’s syndrome the results will be available in three days from the test but the minor anomalies take longer time which may extend to 3 weeks.
You will receive a phone call from dr Wael’s center to schedule a meeting with the parents to discuss the test results.
What is the adverse effect of the procedure?
- 0.1% of women may experience miscarriage within the first 5 days following the procedure, if you had miscarriage after that this won’t be related to the procedure or the CVS which is obtaining a bite from the placental tissue.
It is important to seek urgent advice if you diagnosed having fetal obstructive uropathy, which is the presence of obstruction in the pathway of the fetal urine leading to decrease in the amount of amniotic fluid surrounding the baby leading to compression of the fetal lung making it non-functioning after birth. Also its causes back pressure on the fetal kidneys and destroying it.
At our centre, we provide intrauterine insertion of fetal catheter to withdraw that accumulating urine to save the fetal kidneys.
This procedure is considered the only solution for saving the twin who share the same placenta and having abnormal vascular connection between them, which lead to more blood passing to one of the twin causing fetal edema and heart failure while the other fetus will be anaemic and may die.
Dr Wael diagnoses that condition early in pregnancy at the 4th month gestation and through using a very tiny fetoscope which is like a telescope passing through your abdomen and then through the uterine wall and uses laser beam to destroy this connection between the fetal circulations.
Some fetuses experience increased amount of the amniotic fluid surrounding them while they are inside the uterine cavity.
This condition happens more with diabetic women and sometimes it has no identifiable cause.
This may lead to preterm rupture of membranes and other complications.
Dr Wael manages this condition through aspiration of some of the excess fluid over multiple sessions o relief the mother’s symptoms. This is done through ultrasound guide and followed by confirmation of fetal wellbeing.
Some fetuses may have obstruction in their urine flow leading to reduction in the amount of amniotic fluid surrounding them, which is adversely affecting fetal wellbeing including their lung development.
This condition is usually diagnosed during the second trimester of pregnancy.
Dr Wael performs amnioinfusion in these conditions through injecting adequate amounts of certain fluids to protect these babies from developmental anomalies like adhesions affecting their limbs
Some women have a condition known as Rh isoimmunisation, which is characterized by presence of antibodies within the maternal blood attacking the fetal red blood cells destroying it.
This will be flowed by fetal heart failure, fetal edema and jaundice.
This condition needs to be accurately evaluates through a specific ultrasound imaging to diagnose the presence and the degree of fetal anemia.
At these situations, dr Wael performs blood transfusion to these fetuses while thy are still intrauterine to save them from the adverse effects of fetal anemia.