Transabdominal isthmic amniocentesis

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      In transabdominal isthmic amniocentesis, the suprapubic region is punctured after cephalad displacement of the presenting part. It has been claimed to be far less traumatic than the conventional techniques using the space behind the fetal neck or that occupied by the fetal small parts. This was verified in a controlled study of amniocenteses performed during the 3rd trimester of pregnancy on 100 patients with a vertex presentation: isthmic amniocentesis was more often successful and less traumatic than the conventional methods (5% cf. 44% blood stained liquor specimens). Isthmic amniocentesis, however, appears less satisfactory in breech presentation (27% traumatic punctures in a series of 15 patients). Incisional scars of previous lower segment cesarean sections did not prove to be a contraindication for the procedure.



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