A cohort study of pregnancy outcome after amniocentesis in twin pregnancy

Abstract

We conducted a retrospective cohort study to assess the risk of amniocentesis in twin pregnancy for adverse outcomes. The study base consisted of women who had an amniocentesis performed during twin pregnancy and a comparison representative sample of women who carried a twin pregnancy, but did not have invasive prenatal diagnosis. The 227 women in each of the exposed and non-exposed groups were residents of the state of New South Wales, Australia, over the period 1980-92, and were matched on maternal age and period of the infant's birth. Nearly 10% of twin pregnancies among the women having an amniocentesis were affected by a stillbirth, and the stillbirth rate among exposed fetuses (5.3%) was nearly twice as high as among non-exposed fetuses (3.1%). After adjustment for confounding and excluding abnormalities, there was a non-significant elevated relative risk of stillbirth after exposure to amniocentesis. The analysis by type of amniocentesis (with and without methylene blue dye) was limited by small numbers, but the burden of risk was primarily among women who had dye exposure during amniocentesis (relative risk = 3.64, 95% confidence interval = 1.15, 11.48). This increase remained after adjusting for confounding, although the confidence interval was wide. In conclusion, we were unable to establish with certainty whether an increased risk of stillbirth could be ruled out among women who had any type of amniocentesis in twin pregnancy.

Outcome of twin pregnancies after amniocentesis

“…Earlier reports described the spontaneous abortion rate up to 28 weeks 11,12,18 . While most reported the miscarriage rate of both fetuses before 24 weeks, one reported loss before 20 weeks 13 . Therefore, in compiling the summary in Table 3, specific information was retrieved from the paper rather than quoting the reported rate from the abstract in view of the variations discussed above.…”

Current concepts of Down syndrome screening tests in assisted reproduction twin pregnancies: another double trouble

“…Thus, in twins, serum screening may lead to an 18% amniocentesis rate in this group (similar to our recent experience, Table 1). This has serious perinatal consequences since the fetal loss related to amniocentesis is more than double in twins compared to matched singletons (Kidd et al, 1997).…”

Second trimester amniocentesis in assisted conception versus spontaneously conceived twins

“…Therefore, it is not unusual for patients with twin pregnancies to seek prenatal diagnosis. The decision to undergo prenatal diagnosis is complex, and one must consider not only the risk of aneuploidy but also the procedure-related risk, which seems to be significantly higher in twins compared with singletons (5,6). Amniocentesis is the method of choice in such cases in most of the centers.…”