One caveat: ( When you’re a nurse as long as I have been a nurse you have a lot of horror stories.) AmnioSense (Common Sense Ltd) is a non-invasive diagnostic pad. The pad is designed to assess unexplained vaginal wetness during pregnancy. Vaginal wetness can result from leaking amniotic fluid and may indicate amniotic membrane rupture. Premature membrane rupture needs urgent medical attention. We actually talk a bit about the AFI and other 3rd trimester tests in my free prenatal class. What does amniotic fluid smell like and look like? Having an earlier pregnancy affected by a genetic condition. A health care provider might suggest amniocentesis to look for that condition. The duration of an amniotic fluid examination generally takes about five to 15 minutes. Although most women do not find the procedure painful, other expectant mothers complain of sometimes considerable pressure. In most cases, local anesthesia is not used.

Miscarriage. Second-trimester amniocentesis carries a slight risk of miscarriage — about 0.1% to 0.3% when done by a skilled person using ultrasound. Research suggests that the risk of pregnancy loss is higher for amniocentesis done before 15 weeks of pregnancy. The incidence of PROM said to be between 5% and 10% of all deliveries while that of PPROM is put at 3% and it is the cause of over a third of preterm deliveries.[ 3, 4] It is a significant cause of maternal and perinatal morbidity and mortality. Risk factors include polyhydramnios, low socioeconomic status, and low body mass index. There was no increased risk of PROM among obese patients in Ahmed et al.’s study.[ 5] Maternal effects include endometritis, salpingitis, and sepsis.[ 6] Fetal complications may include fetal lung hypoplasia, umbilical cord compression, chorioamnionitis, neonatal sepsis, and many others.[ 7, 8]Your health care provider will likely proceed to deliver the baby if the hospital has neonatal care available. According to Sanford Health, two-fifths of women at this stage will deliver the baby within a week. Many will deliver within 48 hours. Another serious complication is umbilical cord compression. Without amniotic fluid, the umbilical cord is vulnerable to damage. The umbilical cord delivers oxygen and nutrients to the baby and is normally protected by the amniotic fluid. If the fluid leaks out, the umbilical cord may get compressed between the baby and the uterus or in some cases, fall out of the uterus into the vagina. This can lead to serious brain injuries and even death. Testing.com [Internet]. Seattle (WA): American Association for Clinical Chemistry; c2001–2020. Amniotic Fluid Analysis; [updated 2019 Nov 13; cited 2020 Mar 9]; [about 2 screens]. Available from: https://www.testing.com/tests/amniotic-fluid-testing/ These results are quite different from several other studies as mentioned above. Possible reasons for such low values could be a result of interference from components of amniotic fluid[ 32, 33] the influence of these interfering substances could be complex interfering either negatively or positively. Furthermore, ethnicity, differences in selection criteria and laboratory techniques could also possibly be factors responsible for the differences. Of the two, creatinine showed to be more reliable than urea in predicting PROM (k values of 0.156 and 0.141 and diagnostic accuracy of 57.8% and 57.0% respectively). This is similar to the finding of Kariman et al.[ 26] However Hanfy reported that[ 25] urea was more reliable than creatinine while Mohammed et al.[ 2] discovered that they were both of equal reliability. Leaking amniotic fluid. Rarely, amniotic fluid leaks through the vagina after amniocentesis. In most cases, the amount of fluid lost is small and stops within one week with no effect on the pregnancy.

ACOG: Women's Healthcare Physicians [Internet]. Washington D.C.: American College of Obstetricians and Gynecologists; c2022. The Rh Factor: How It Can Affect Your Pregnancy; [reviewed 2020 Jun; cited 2022 May 9]; [about 19 screens]. Available from: https://www.acog.org/womens-health/faqs/the-rh-factor-how-it-can-affect-your-pregnancy Risks of PROM at term are related to serious neonatal consequences such as pre-term delivery, fetal distress, prolapsed cord, abruptio placentae and infection (2). pPROM accounts for 20% to 40% of PROM cases, and is associated with 20% to 50% of premature births. Complications of pPROM include infectious morbidity in the mother and fetus, pulmonary hypoplasia of the fetus, prolapse of the umbilical cord, development of fetal deformities, and postnatal endometritis (2). All of these consequences significantly increase risk of fetal and maternal morbidity and mortality. That being said, most often if you wonder if it’s broken, but instead put on a pad and watch it for 15-20 minutes to see if you’re still leaking. That should be fine. Premature rupture of membrane (PROM) can be defined as rupture of membranes before onset of labor, if this occurs before 37 weeks of gestation it is defined as preterm PROM (PPROM) and if at 37 weeks and beyond as PROM or term PROM.[ 1, 2]

Is there anything else I need to know about amniocentesis?

ACOG: Women's Healthcare Physicians [Internet]. Washington D.C.: American College of Obstetricians and Gynecologists; c2022. Prenatal Genetic Diagnostic Tests; [reviewed 2020 Nov; cited 2022 May 9]; [about 20 screens]. Available from: https://www.acog.org/womens-health/faqs/prenatal-genetic-diagnostic-tests Rh sensitization. Rarely, amniocentesis might cause the baby's blood cells to enter the pregnant person's bloodstream. Those with Rh negative blood who haven't developed antibodies to Rh positive blood are given an injection of a blood product, Rh immune globulin, after amniocentesis. This prevents the body from making Rh antibodies that can cross the placenta and damage the baby's red blood cells.