Amniocentesis: preparation and recovery

Meeting with a genetic counselor

Some gynecological offices offer genetic counselling with an amniocentesis. These counselors will outline the various genetic diseases that the amnio will check for and the probabilities associated with each. Offices that provide this service will encourage you to see the genetic counselor for a brief 15 minute session prior to the procedure. You would also sign a waiver in this consultation regarding the information they have shared.

What to expect during the procedure

Your doctor will use an ultrasound to see the location of the baby and your uterus. The doctor or assissting nurse will cover your belly with iodine and other disinfectinants. They may put a numbing cream on your skin. Once everything is all prepared, they will insert the needle carefully. Your doctor will then draw 3 or so viles of amniotic fluid. The needle is then removed and the site is cleaned and a small bandage or bandaid placed on it. While the needle does seem daunting, most women claim that the experience is not nearly as bad as they expected.

You can expect to feel the following:

• A slight sting at the time of needle insertion
• A contraction or cramp at the time that the needle moves through the uterine wall.
• A drawing or pulling sensation as the amniotic fluid is pulled up into the needle. This generally does not take more than a few minutes. This is not painful and it is important to continue to breath slowly and easily.
• A slight stinging when the needle is removed.

Preparation for an Amniocentesis

Minimal preparation is required for the procedure. You can eat as you normally would the day of the procedure. You can even get exercise before the procedure, (but NOT after.)

Here are a few steps you can take to make the procedure go as smoothly as possible:

• No aspirin or blood thinners. If you are taking baby aspirin or blood thinners, let the doctor or nurse know before the scheduled procedure. Because blood thinners can increase the chance of bleeding from the procedure, most doctors recommend that you stop taking them a week beforehand.
• Have a full bladder. You will need a full bladder for the test itself. A full bladder will press on your uterus making it easier to see things during the ultra-sound. No need to start drinking hours before, 15-30 minutes before the procedure should be ample.
• Relax. It is always helpful to come to medical procedures well rested and relaxed. If you can, get a good night's sleep prior to the amnio. If you are very nervous for the procedure, pratice relaxation exercises, such as calming breath, clearing the mind, and slow, gentle stretching.

Recovery from the Amniocentesis

Possible side effects from the procedure

The procedure itself is not as uncomfortable as people fear it will be. In fact, many people feel lots of relief when the amnio is over. You may experience some side effects due to the procedure. These might include:

• Emotional fatigue.
• Uterine cramping, tightness and abdominal soreness. The cramping is likely to last up to 24 hours.
• Some fluid leakage or light bleeding (much less than a normal menstrual period.) If you experience fluid leakage or bleeding, bed rest is recommended.

Minimizing miscarriage risk

Due to risk of miscarraige associated with the procedure, there are a few steps that can help to minimize this.

• Immediate rest for 2 hours.When you get home, lie down and rest for at least 2 hours following the procedure.
• Inactivity for 24 hours. While it is not necessary to remain in bed after the procedure, it is a good idea to stay off your feet. This means taking the rest of the day off after the procedure. Go home and just relax. You can return to work the following day (assuming you have a sedentary job.
• No lifting for 24 hours. It is recommened not to lift more than 15 pounds for at least 24 hours after the procedure.
• No sexual activity for 24 hours. It is obvious that sex might irritate the already delicate area. It might also contribute to uterine or cervical contractions which could increase the liklihood of miscarriage.
• No exercise or strenuous work for 72 hours. Refrain from any form of physical strenous activity for up to 72 hours after the procedure. Light walking is ok when used as means to completing your daily tasks. However, power walking or exercise walking is not recommended.
• No air travel within 72 hours.
• No tampons. Do not use tampons if you are experiencing leakage or bleeding. If it is more than "light" contact your doctor.
• Don't worry. The vast majority of amnios are successful. Miscarriage rates have really declined over the years. If you are with a doctor who performs many of them every year, chances of miscarriage are even lower.
• Practice Relaxation breathing. If you find that you are getting really stressed about miscarriage or the results from the test, practice relaxation techniques. Simple relaxation techniques can include lying on your back with your legs elevated and focusing on calm, steady breathing moving in and out of the body. Practice this for 10-20 minutes. Every time the mind wanders or you get pulled into a state of stress, come back to the calm, slow breathing.

When to alert your doctor

Let your doctor know right away if you experience any of the following symptoms following your amniocentesis:

• Extreme cramping lasting more than 24 hours
• Heavy bleeding or passing of clots or tissue or leaking lots of clear (amniotic) fluid.
• A fever greater than 100F or 38C.
• A worsening infection at the site of the needle insertion that is not responding to antiobiotic cream.

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