Transabdominal Amniocentesis Is a Feasible and Safe Procedure in Preterm Prelabor Rupture of Membranes

Abstract

Objectives: To determine the feasibility and the complication rate of amniocentesis in a large cohort of women with preterm prelabor rupture of membranes (PPROM).

Methods: A retrospective cohort study was conducted in all women with singleton gestation complicated by PPROM at between 24+0 and 36+6 weeks admitted to the Department of Obstetrics and Gynecology, University Hospital Hradec Kralove, Czech Republic between May 2008 and July 2016. Amniocentesis was offered as a part of a routine protocol of PPROM for the detection of microbial invasion of the amniotic cavity and intra-amniotic inflammation. Procedure was performed under ultrasound guidance. A successful procedure was defined as obtaining at least 0.5 mL of amniotic fluid. No more than 2 attempts were performed.

Results: In total, 590 women with PPROM were included. Amniocentesis was successful in 96% (567/590). Two amniocentesis attempts were necessary in 9% (55/590) and the transplacental approach was used in 13% (76/590). No association between gestational age at sampling and the amniocentesis failure rate was found (Spearman rho -0.12; p = 0.71). The complication rate was 0.7% (4/590). Two umbilical cord punctures and 2 chorionic plate fetal vessel injuries occurred, without fetal morbidity.

Conclusion: Based on our study population, so far the largest published, amniocentesis is a feasible and safe procedure carrying a very low risk of failure or complications in PPROM.

Keywords: Amniocentesis; Intra-amniotic infection; Intra-amniotic inflammation; Preterm rupture of membranes; Safety.