A single physician's experience with four thousand six hundred genetic amniocenteses.

ABSTRACT

OBJECTIVE: We sought to assess changes in indications, technique, successful fluid aspiration, and pregnancy outcomes in a large cohort of genetic amniocenteses performed by a single physician. STUDY DESIGN: Records were reviewed regarding 4600 women who underwent genetic amniocentesis by a single physician between 1972 and 2000. Changes in indications, procedural technique, ease of performance, amniotic fluid reports, and pregnancy loss rates were tabulated and compared over time. RESULTS: The indications for amniocentesis changed significantly (P < .0001) over time with the increasing use of maternal serum screening studies and fetal assessment by ultrasonography. The ease with which clear amniotic fluid was aspirated increased with experience, improvements in ultrasound technology, and modifications of amniocentesis technique. Procedure-related total pregnancy loss rate was 0.95%, and loss rate within 60 days of the procedure was 0.55%. Increasing operator experience did not improve the pregnancy loss rate significantly. CONCLUSIONS: Successful aspiration of clear amniotic fluid increases with amniocentesis experience. Pregnancy outcome did not change significantly with increasing amniocentesis experience.