Complications of amniocentesis.

A retrospective survey of 358 consecutive amniocenteses was undertaken. The incidence of failure was 37 (9.6%); most commonly this was due to oligohydramnios. A suprapubic tap was the most likely to be successful, but was accompanied by premature rupture of membranes in 3.8% of the cases. Spontaneous rupture of membranes, followed by delivery of a premature infant, occurred 15 times (4.2%). Blood-stained fluid was obtained on 47 occasions (13%), but, apart from the theoretical risks of fetomaternal haemorrhage and fetal exsanguination, and an association with maternal abdominal pain, there appeared to be no serious sequelae from this complication. Withdrawal of blood-stained fluid was not prevented by prior placental localization and was not related to the site of the tap. There were 14 perinatal deaths (equal to a rate of 50 per 1,000 births) and, although no fetal deaths could be directly attributed to amniocentesis, there were four cases in which the procedure could not be completely absolved. Three patients underwent emergency caesarean section because of severe abdominal pain after anmiocentesis. Two had amniotic fluid peritonism and the third had minor intraperitoneal bleeding. Amniocentesis is not without maternal and fetal complications and should be undertaken with due regard to the risks involved.