Early amniocentesis with the filtration technique: neonatal outcome in 123 singleton pregnancies.

OBJECTIVE: To evaluate results of a prospective study of pregnancies in which early amniocentesis with the filtration technique was performed at 10-13 weeks' gestation (mean 12.3 weeks' gestation). METHODS: 123 singleton pregnancies in which early amniocentesis with the modified filtration technique was performed at 10-13 weeks' gestation (mean 12.3 weeks' gestation). The amniotic fluid was aspirated into the syringe and reinjected through the filter. RESULTS: All the procedures were performed successfully by a single needle insertion. Neither dry taps nor filtration failures occurred. The mean time of amniocentesis was 4.02 min (95% confidence interval, 3 min and 36 s to 4 min and 18 s). The karyotyping success rate was 99.2%. Temporary amniotic fluid leakage occurred in three women (2.4%). There were 110 (89.4%) live births. Two cases of stillbirth occurred at week 38 and week 40. Two unintended losses occurred within three weeks after sampling (1.62%). Another additional unintended fetal death was notified at the 20-week screening ultrasonography. The total fetal-loss rate was 10.6%. In one case, talipes equinovarus was detected at the 20-week screening ultrasound study. CONCLUSIONS: Further studies are needed to determine the risk of amniotic leakage and its relation to duration of the procedure in patients undergoing early amnifiltration.

[Spina bifida: management after 25 years]. / Espina bífida. Planteamiento después de 25 años.

The authors present their experience of 468 patients with spina bifida treated in a period of 25 years. They discuss the philosophy of the management of the severe neural tube defects based in the follow up of these patients. This attitude is based in the prevention that could be: 1) following Smithells theory; 2) trying a prenatal diagnostic before 20 weeks of pregnancy, and 3) doing a selection of spina bifida that could be operated.