Question about amnios?

Burnt Out, ASN, RN · Oct 12, 2004

hi. i have a question and it is keeping me awake and i am wanting some professional and/or honest opinions.

a little about what is going on: i have mentioned here before about my 1st child, a son, who died when he was 12 days old. he was born at 32 weeks due to my pih and the placenta starting to fail. blake was born with bilateral cleft lip and palate, hemivertebrae and tetralogy of fallot. we had no idea he was so sick until his birth as all the us in my pregnancy, we never saw any of these things due to his position in the womb.

i am now 10 weeks pregnant again. the dr i am seeing is not the dr i had in my pregnancy with blake, but is fully aware of all the complications we had in our first pregnancy and of blake's death.

in 6 weeks, we will be going to uab hospital for very high level us and a fetal echocardiogram and my ob/gyn has told me that we may be having an amnio depending on what they find on all the scans. i know the amnio has basically around a 1% miscarriage rate. it took almost 2 years to conceive again (and a lot of procedures) so i am very guarded about this baby. my husband and i have talked about the amnio since the day i learned i was pregnant again as my ob/gyn told me we probably would have one and we would not terminate no matter what-i've decided that if this baby is sick too, i will carry him/her for as long as i can. and if there is something wrong when he/she is born, we will deal with it-just as we would have done anything on this earth to take care of blake. :crying2:

my question is this: honestly, how many times have you seen a patient lose their baby after an amnio-due to infection, pre-term labor, or late term miscarriage?

i know they can not force the amnio, but if there is any chance this baby wouldn't get to come home because of complications from an amnio......well....it would just be devestating. :crying2:

i am sorry if this is difficult to read, it is 2 am where i live and i just had to get this out of my mind where maybe i can sleep. :rolleyes:

CEG · Oct 12, 2004

I am not a nurse, just a student, but you can refuse the amnio if it wouldn't affect your decision to continue the pregnancy. You can refuse anything you are not comfortable with. The only potential problem I know of is maybe not knowing in advance of a condition that would need to be be treated at birth.

I had a cleft palate when I was born and from the research I did you are only .7 -.8% likely to have another child with the same problem, unless you had it also, then your chances increase to 3-4%. I would recommend the book The Thinking Woman's Guide to a Better Birth by Henci Goer. It is pretty anti-intervention but it gives a lot of unbiased info.

Hope that helps, best wishes!

CEG · Oct 12, 2004

I am not a nurse, just a student, but you can refuse the amnio if it wouldn't affect your decision to continue the pregnancy. You can refuse anything you are not comfortable with. The only potential problem I know of is maybe not knowing in advance of a condition that would need to be be treated at birth.

I had a cleft palate when I was born and from the research I did you are only .7 -.8% likely to have another child with the same problem, unless you had it also, then your chances increase to 3-4%. I would recommend the book The Thinking Woman's Guide to a Better Birth by Henci Goer. It is pretty anti-intervention but it gives a lot of unbiased info.

Hope that helps, best wishes!

TXMomRN · Oct 12, 2004

I had an amnio (well, 2) with my twins when some tests looked really suspicious and since my husband AND my Dr were out of town and the on call doc recommended this, I was freaked, and went ahead with it. I can still hear her saying "you *need* genetic testing and an amnio"....

I would not have changed any course of action based on this, and looking back - if my own Dr had been there and been reassuring that other noninvasive tests would have done (as she did when she came back) - I would have gone that route.

I have never seen or personally heard of a pregnancy loss due to an amnio, and based on what you have said, and the advances in technology over the past few years, I would not proceed if you thought the risks outweighed the benefits. It's still invasive, and has risks. So, as my Dr told me when she was back in town - if it would not have changed your course, why put yourself through it?

BTW the amnio was no picnic, but my babies were perfect... thank God!

Love your baby and take care of your body and I'll keep you in my prayers : )

TXMomRN · Oct 12, 2004

I had an amnio (well, 2) with my twins when some tests looked really suspicious and since my husband AND my Dr were out of town and the on call doc recommended this, I was freaked, and went ahead with it. I can still hear her saying "you *need* genetic testing and an amnio"....

I would not have changed any course of action based on this, and looking back - if my own Dr had been there and been reassuring that other noninvasive tests would have done (as she did when she came back) - I would have gone that route.

I have never seen or personally heard of a pregnancy loss due to an amnio, and based on what you have said, and the advances in technology over the past few years, I would not proceed if you thought the risks outweighed the benefits. It's still invasive, and has risks. So, as my Dr told me when she was back in town - if it would not have changed your course, why put yourself through it?

BTW the amnio was no picnic, but my babies were perfect... thank God!

Love your baby and take care of your body and I'll keep you in my prayers : )

SmilingBluEyes · Oct 12, 2004

In having ANY test, you must consider if the risk of said test is worth it. And what will you DO with the result? If you would carry the pregnancy to term, regardless---and termination is unacceptable to you, you may wish to forgo the testing. I had a previous baby w/a birth defect, requiring surgery. They offered amnio to me for the 2nd one, after a Level-2 U/s showed all seemed ok w/her. I refused. I was NOT going to abort, if there was a problem, and I would deal with it when the baby was born. they tried to pressure me into it, saying the doctor as well as me had the right to know what may be coming. I said we could deal with anything at birth, but I was NOT doing it. No one strongarms me into anything, rofl. BUT---That is MY scenario.

If you cannot stand not knowing, then perhaps amnio MAY be for you . You would then know what is coming and possibly be spared such a heartbreaking outcome at birth. Yes, I can see why you are considering it now and feel your tension from here. I can indeed imagine how hard it was for you the first time---and why you may wish to have amnio done this pregnancy. I have had a baby w/a defect and have lost 4 pregnancies myself. I would respect and support that decision TO have the amnio, knowing it does put you in the "driver's seat" regarding defects and what to do next.

But again you do court that approximately 1% chance of spontaneous abortion post-amniotcentesis. It's up to you in the end, as you know. Be sure you get genetic counseling first! That alone can help you weigh the risk of repeating defects. The chance of my next baby having the same defect was not great enough for me to wish to risk miscarriage for amnio. Like I said, I urge you to think what you would do with such information before you consider seeking it!

I support you either way. If you need anything just let us know or PM me.

HUGE HUGS and here's to a healthy pregnancy and baby! :)

veteranRN · Oct 12, 2004

We were faced with the decision of having an amnio with our 4th child but decided against it because the results, no matter what they were, would not have changed our course of action. We would carry the baby to term regardless of the results. It was the right decision for us and the baby turned out fine. Good luck and best wishes for you and your baby.

HOPE2BNP · Oct 12, 2004

i am sorry to hear about all you have been through. of course this would make your discision very difficult. i should add i am not a nurse yet, but i am here to offer a lay person's opinion. before moving forward i would ask my doctor about the risk of not doing the amnio. what i mean is that there is always the chance that if you don't do it, your doctor won't know about something he or she can treat. if the chances of this are greater than the chances of spontaneous abortion because of the amnio, than you should probably do it. otherwise, trust your heart.

hi. i have a question and it is keeping me awake and i am wanting some professional and/or honest opinions.
a little about what is going on: i have mentioned here before about my 1st child, a son, who died when he was 12 days old. he was born at 32 weeks due to my pih and the placenta starting to fail. blake was born with bilateral cleft lip and palate, hemivertebrae and tetralogy of fallot. we had no idea he was so sick until his birth as all the us in my pregnancy, we never saw any of these things due to his position in the womb.
i am now 10 weeks pregnant again. the dr i am seeing is not the dr i had in my pregnancy with blake, but is fully aware of all the complications we had in our first pregnancy and of blake's death.
in 6 weeks, we will be going to uab hospital for very high level us and a fetal echocardiogram and my ob/gyn has told me that we may be having an amnio depending on what they find on all the scans. i know the amnio has basically around a 1% miscarriage rate. it took almost 2 years to conceive again (and a lot of procedures) so i am very guarded about this baby. my husband and i have talked about the amnio since the day i learned i was pregnant again as my ob/gyn told me we probably would have one and we would not terminate no matter what-i've decided that if this baby is sick too, i will carry him/her for as long as i can. and if there is something wrong when he/she is born, we will deal with it-just as we would have done anything on this earth to take care of blake.
my question is this: honestly, how many times have you seen a patient lose their baby after an amnio-due to infection, pre-term labor, or late term miscarriage?
i know they can not force the amnio, but if there is any chance this baby wouldn't get to come home because of complications from an amnio......well....it would just be devestating.
i am sorry if this is difficult to read, it is 2 am where i live and i just had to get this out of my mind where maybe i can sleep.

fergus51 · Oct 12, 2004

I think the question you need to ask is "what will change if we get a bad result from the amnio"? If it won't change anything, then I see no reason to do it and subject the pregnancy to any risk unless you feel you NEED to know.

Jolie, BSN · Oct 12, 2004

The others have offered you great information about weighing the risks and benefits of having an amnio. I too, opted against amnios with my pregnancies despite having multiple risk factors. I wouldn't have terminated them regardless of the results, so I didn't see any reason to undergo the procedure. I delivered at high-risk centers, so the possibility of having to transport my babies for intensive care was not an issue either.

As you know, there is a small risk of pregnancy loss associated with amniocentesis. A friend of mine had an amnio done about a year ago due to maternal age of 35. Her membranes ruptured, and she lost the baby about a week later. What most upset her was that statistically, her risk of delivering a Down's Syndrome baby, (essentially the reason for doing the amnio) was less than her risk of pregnancy loss due to the test.

She didn't really understand that before consenting to the procedure.

Were Blake's problems genetic in nature? Not all birth defects are genetically based, and those that aren't won't be detected by amniocentesis.

Finally, keep in mind your right to decline ANY test or procedure. Best wishes to you, and may God bless your little angel.

allnurses Guide · Oct 12, 2004

All really good advice here.

I had an amnio with my last child. I was 43 and pregnant which was a shock to my husband and me. We had genetic testing, the diagnostic sono and still we were encouraged to have amnio. I think because we were in shock we went ahead and had the amnio even though the results would not have changed anything. We were told at least the docs would know what to expect.

The procedure itself was not a big deal - no pain. It was scary though.

Waiting for results was hard. But everything turned out ok - no birth defects and no problems with my pregnancy.

This is an individual question and you've gotten some great advice. I wish I'd known about allnurses when I was faced with the choice. I would not have had the amnio.

Best wishes and keep educating yourself.

steph