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Re: genetic amniocentesisFrom: DuBose, Terry (DuboseTerryJ@uams.edu)Mon May 20 15:34:00 2002
Dr. Sanchez-Ramos, I did quick search on OBGYN.net using their "plain English" interface to Medline with the following query. Got over 300,000 hits. Looking at the first 10 or so there does not seem to be anything specific to the stylette; however, my query wording may not be the best. "Does not reinserting the stylette after amniocentesis lead to infection? " You might be able to refine my search at this site: http://www.obgyn.net/medline.asp Here are two of the abstracts that came from the above search. Good luck. Forwarded to you from Aries Systems Corporation <KWEB-SERVER> at the request of <DuBose@io.com> UI - 21002380 TI - [Septic shock complicating amniocentesis] TT - [Choc septique compliquant une amniocentese.] SO - Gynecol Obstet Fertil 2000 Nov;28(11):832-4 TA - Gynecol Obstet Fertil VI - 28 IP - 11 PG - 832-4 DP - 2000 AU - Thabet NP AU - Thabet H AU - Zaghdoudi I AU - Brahmi N AU - Chelli H AU - Amamou M AD - Service de gynecologie obstetrique A, centre de maternite, La Rabta, Tunis, Tunisie. AB - Amniocentesis is a routine technique for prenatal diagnosis. The incidence of severe intra-amniotic infection is very low. We report a case of septic shock following an amniocentesis in a 34-year-old women. Patient admitted in intensive care unit and need mechanical ventilation and vasoactives drugs to control hemodynamic pertubation. Bacteriological data showed positive polymicrobial blood cultures to Klebsiella pneumoniae and Enterobacter. The patient gradually improved, however her renal function was still impaired and she was discharged three months after admission. IS - 1297-9589 MJ - Amniocentesis [adverse effects] MJ - Shock, Septic [etiology] MN - Adult MN - Bacteremia [etiology] [microbiology] MN - Enterobacteriaceae Infections [blood] MN - Enterobacter [isolation & purification] MN - Klebsiella Infections [blood] MN - Klebsiella pneumoniae [isolation & purification] MN - Pregnancy MN - Shock, Septic [microbiology] MT - Case Report; Female; Human LA - French PT - Status: Completed MC - English Abstract EM - 200101 UI - 98387237 TI - Intrauterine viral infection at the time of second trimester genetic amniocentesis. SO - Obstet Gynecol 1998 Sep;92(3):420-4 TA - Obstet Gynecol VI - 92 IP - 3 PG - 420-4 DP - 1998 AU - Wenstrom KD AU - Andrews WW AU - Bowles NE AU - Towbin JA AU - Hauth JC AU - Goldenberg RL AD - Center for Obstetric Research, Department of Obstetrics and Gynecology, The University of Alabama at Birmingham, 35233-7333, USA. AB - OBJECTIVE: To determine whether preexisting intrauterine viral infection is associated with postamniocentesis pregnancy loss. METHODS: We accessed our bank of second-trimester amniotic fluid (AF) samples obtained aseptically and stored at -20C from all 11,971 women who underwent genetic amniocentesis between 1988 and 1995. Samples were retrieved from every case of spontaneous pregnancy loss within 30 days of the amniocentesis (excluding aneuploidy and anomalies, n = 66). Sixty-six control samples were randomly chosen from subjects who delivered at term and were matched for year of test, gestational age, maternal age, and indication for amniocentesis. Investigators were blinded to the status of the samples, which were studied by polymerase chain reaction (PCR) for the presence of adenovirus, parvovirus, cytomegalovirus, Epstein-Barr virus, herpes simplex virus, enterovirus, influenza A virus, and beta-actin DNA. Results were compared with interleukin-6 (IL-6) levels pre! viously measured by enzyme-linked immunosorbent assay in the same samples. RESULTS: Sixty-two study cases and 60 controls were sufficient for all PCR studies. Fourteen AF samples contained a single virus: five (8%) of 62 study cases and nine (15%) of 60 controls (P = .27). Adenovirus accounted for nine (64%) of 14 viruses identified: four of 62 cases and five of 60 controls (P = .74). Cytomegalovirus was not identified in any study cases but was found in three controls. The mean IL-6 levels in samples with and without virus were not significantly different (4.8+/-15.9 ng/mL with virus compared with 2.0+/-8.8 ng/mL without virus; P = .53). CONCLUSION: Presence of virus in second-trimester AF is not significantly associated with elevated IL-6 levels or with early postamniocentesis pregnancy loss. IS - 0029-7844 MJ - Abortion, Spontaneous [virology] MJ - Amniocentesis [adverse effects] MJ - Pregnancy Complications, Infectious [virology] MJ - Virus Diseases [etiology] MN - Amniotic Fluid [chemistry] MN - Interleukin-6 [analysis] MN - Polymerase Chain Reaction MN - Pregnancy Trimester, Second MN - Pregnancy RN - 0 (Interleukin-6) MT - Female; Human; Support, U.S. Gov't, P.H.S. LA - English PT - Status: Completed EM - 199809 ID - DHHS 290-92-0055 Peace, Terry J. DuBose, M.S., RDMS Assistant Professor & Director, Diagnostic Medical Sonography Program CHRP, University of Arkansas for Medical Sciences Little Rock, Arkansas, USA 501-686-6510 http://www.io.com/~dubose/ http://www.uams.edu/CHRP/dmshome.htm http://www.obgyn.net/us/panel/panel.htm -----Original Message----- From: luis.sanchez@jax.ufl.edu [mailto:luis.sanchez@jax.ufl.edu] Sent: Monday, May 20, 2002 3:08 PM To: Multiple recipients of list ULTRASOUND Subject: genetic amniocentesis Listers: I have been performing genetic amniocentesis for many years and have always re-inserted the stylette after completing the removal of fluid. I was taught to do that and have alwyas done it. The theory behind it is that by not re-inserting the stylette, one leaves a "track" which potentially can lead to infection. Does any one have any data which documents or supports this? Thanks Luis Sanchez-Ramos, MD
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