By amnioscopy trying to obtain direct visualization of the amniotic fluid. It is done with a amnioscope which is inserted into the cervical canal has been previously dilated by 1.5 to 2.5 cm. This will get a view of the fluid without a sample of it for laboratory analysis.

Usefulness of the test

The amnioscopy is used to detect the presence of meconium in the amniotic fluid by observing its color. In many cases meconium staining of the fluid may indicate hypoxia and, therefore, suffering and even fetal death, but sometimes can be seen in normal pregnancies.

It is also sometimes used when the bag is broken, to take samples of blood through the scalp of the fetus.Contraindications

- Patients who are in labor.
- Premature rupture of membranes.
- Active infection at the cervix.

Tips & Warnings

- The test requires no sedation or fasting, or any other preparation.
- The duration of the process is 10 to 20 minutes.
- Dilation of the cervix often cause some mild discomfort during maneuvers.
- One possible complication is rupture of the placental membrane.
- After performing the test may feel some discomfort similar to those seen during menstruation.

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There are some basic things that every woman can do to increase your chances of having a healthy pregnancy and healthy baby:

- Screening with your doctor before pregnancy.
- Get regular prenatal care from early pregnancy.
- Take a multivitamin containing 400 micrograms of folic acid beginning before pregnancy and during the first months to prevent neural tube defects.
- Eat healthy foods, including foods containing folic acid and folate (the form of folic acid that is naturally present in food), such as fortified breakfast cereals, products made from fortified cereals, legumes, green leafy vegetables and orange juice.- Do not eat undercooked meat or change the cat litter. Both are possible sources of toxoplasmosis, an infection that can cause birth defects.
- Avoid contact with all rodents, including hamsters, mice and guinea pigs. These animals can carry a virus harmful to your baby.
- Avoid eating fish species that contain mercury such as shark, swordfish, king mackerel and tilefish. These species may contain high amounts of mercury. Women who are pregnant or plan to become pregnant can safely eat up to 12 ounces per week of fish containing small amounts of mercury, including shrimp, salmon, pollock, catfish and canned light tuna fat. However, you should not eat more than six ounces of albacore tuna (albacore) per week. It also advises women to consult local authorities about the safety of the species from the waters of the area.
- Begin pregnancy at a healthy weight (neither too high nor too low).
- Do not smoke and avoid exposure to cigarette smoke of others.
- Do not drink alcohol.
- No drugs, even prescription medicines or herbal preparations, unless you have been prescribed by a professional who knows of her pregnancy.

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Parents should evaluate with the doctor whether or not an amniocentesis. Genetic counselors, physicians and religious and ethical guidelines can be valuable in helping parents to make a decision regarding prenatal diagnosis and other family planning issues.

Couples who have to choose between a chorionic villus sampling and amniocentesis must consider many factors including the level of technical expertise available, the woman’s medical history, preferences, and the disorder diagnosed.With the exception of neural tube defects (which can not be diagnosed with chorionic villus sampling), both amniocentesis and chorionic villus sample to diagnose the same birth defects. However, both procedures differ slightly in their moment of realization, the speed with which results are obtained and, possibly, risk.

If a screening test indicates a low risk of Down syndrome, some women choose not to have amniocentesis. However, to make the decision, it is important to note that screening tests can not diagnose or rule out Down syndrome definitely or other chromosomal birth defects, as can amniocentesis and chorionic villus sampling.

The amniocentesis decision requires careful planning and a serious analysis of the situation. Women should discuss this with your doctor at a prenatal visit early or even in a preconception visit.

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Most women who undergo amniocentesis receive confirmation that your baby does not have the disorders for which they were tested. However, no prenatal test can guarantee the birth of a healthy baby.

Can doctors treat the birth defects diagnosed by amniocentesis?

Doctors can treat a small number of birth defects diagnosed before birth by drugs, diet or surgery. For example, doctors have diagnosed and treated biotin deficiency and methylmalonic acidemia (hereditary disorders that affect the body’s chemical processes and endangering life) before birth, which has allowed the birth of healthy babies. However, in most cases, birth defects diagnosed by amniocentesis can not be treated before birth.

If a fetus has a birth defect that can not be treated before birth, prenatal diagnosis may help parents to prepare emotionally for their arrival. Parents can plan the delivery with their doctor, so the baby gets all the special care needed just birth occurs. Parents can discuss their options with genetic counselors and doctors.

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Amniotic fluid and fetal skin cells that float in it are subjected to analysis. The cells are separated from the amniotic fluid and cultured in a laboratory for 10 to 12 days. Then, cells are analyzed for chromosomal abnormalities or genetic birth defects. In general, the results are obtained within two weeks.

You can also measure levels of a protein called alpha fetoprotein (AFP) in amniotic fluid to diagnose neural tube defects. AFP levels tend to increase when the baby has a neural tube defect. In general, the results of this test are available within a few days.

Do you have any risks of amniocentesis?

There are rare serious complications of amniocentesis in the second quarter. However, the procedure represents a small risk of spontaneous abortion. According to ACOG, fewer than one in 500 women to one in 300 has a spontaneous abortion after amniocentesis. A recent study suggests that the risk of spontaneous abortion may be just one in 1,600. Other complications such as uterine infections, are rare and occur in less than one in 1,000 cases.We do not recommend performing an amniocentesis during the first quarter. Studies suggest that the risk of spontaneous abortion after amniocentesis during the first trimester may be three times greater than the risk after an amniocentesis in the second quarter.

Studies also suggest that early amniocentesis may increase the risk of a foot deformity called clubfoot. Where it is necessary prenatal testing during the first trimester, chorionic villus sampling is safer than early amniocentesis.

The risk of miscarriage after amniocentesis may be lower when the physician performing the procedure has extensive experience.1 most experienced physicians often work in major medical centers. In general, health professionals and geneticists can refer pregnant women to experienced doctors.

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Usually, amniocentesis is performed during the second trimester between 15 and 20 weeks of gestation. No longer recommended early amniocentesis (performed 11 to 14 weeks after the last menstrual period of women) because it carries a higher risk of spontaneous abortion and other complications compared with amniocentesis during the second quarter.

You can also perform an amniocentesis during the third quarter to diagnose uterine infections and to determine whether fetal lungs are mature enough for delivery (in cases where it is considered a premature birth).

The test also helps assess the severity of anemia in fetuses with Rh disease (an incompatibility between the blood types of mother and baby). This information helps doctors determine if a fetus with Rh incompatibility need a blood transfusion to stay alive.How is an amniocentesis performed?

First, the doctor performs an ultrasound to locate the fetus, placenta and amniotic fluid bags to sample. Then clean the woman’s abdomen with an antibacterial solution. During the procedure, the pregnant woman lies on her back on a table.

Guided by ultrasound, the doctor inserts a thin needle penetrating the abdomen and uterus into the amniotic sac. He then removes about one to two tablespoons of liquid and remove the needle. After sampling, the doctor finds that the fetal heartbeat by ultrasound are normal. The entire procedure only takes a few minutes.

Some women say the procedure is painless at all. Others feel cramping when the needle enters the uterus or pressure when the fluid is removed. From 1 to 2 percent of women experience cramping, spotting or amniotic fluid leakage after the procedure. After the test, most doctors recommend that women avoid strenuous activity and rest during the day.

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Doctors may indicate an amniocentesis taking into account the following factors:

- Age of the mother. The risk of having children with certain chromosomal birth defects increases with age for women. Traditionally, physicians recommend prenatal testing to detect chromosomal disorders if the woman will be 35 years or older at the time of delivery. The most common disorder is Down syndrome, a combination of mental and physical abnormalities caused by the presence of an extra chromosome. One in 1,250 children whose mothers are between 20 and 30 years has Down syndrome. The chances increase to about one in 400 children when the mother is 35 years old, one in 100 at age 40 and one 30 to 45 years.

Currently, women over 35 are performed screening test during the first or second trimester of pregnancy to learn more about their risk before deciding whether to have amniocentesis. The College of Obstetricians and Gynecologists U.S. (American College of Obstetricians and Gynecologists, ACOG) recommends screening tests during the first and second quarters, as well as prenatal testing, women of all ages.

-A previous child or pregnancy with a birth defect. When a woman has already had a child (or pregnancy) diagnosed with chromosomal abnormalities, genetic birth defect, or certain birth defects that affect the brain or spinal cord (neural tube defects) may be advised to do some prenatal tests are during subsequent pregnancies.

-Abnormal screening tests. The screening tests for birth defects can be performed during the first or second quarter. The first trimester test combines a blood test with an ultrasound to measure the fold of the fetal neck (called nuchal translucency). Ultrasound uses sound waves to take a picture of the fetus. The test of first-trimester screening helps determine the risk of women having a baby with Down syndrome or trisomy 18 (a severe chromosomal abnormality).

The proof of the second quarter is a blood test that helps determine the risk of producing the same chromosomal birth defects and neural tube defects. If a screening test suggests an increased risk of birth defects, doctors often recommend an amniocentesis to diagnose or rule out chromosomal abnormalities and to facilitate the diagnosis of neural tube defects. Most babies who have abnormal results on screening tests are born healthy.

- Family history. Doctors may recommend an amniocentesis with a family history of certain birth defects and genetic disorders like cystic fibrosis or fragile X syndrome.

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Amniocentesis is the most common prenatal test used to diagnose chromosomal and genetic birth defects. There is another prenatal test called chorionic villus sampling, which can diagnose the majority of birth defects detected by amniocentesis.The chorionic villus sampling is performed at an earlier stage of pregnancy (usually between weeks 10 and 12) compared with amniocentesis (usually done between weeks 15 and 20), but may involve a slightly increased risk of spontaneous abortion amniocentesis (although recent studies suggest that the risk could be similar when procedures are performed by experienced physicians).

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Eggs, which had been fertilized and implanted there, began to grow. Needless to say this is a very dangerous situation because the fallopian tubes or other areas of the body is not designed to support the baby and also unable to stretch as they need to stretch to make room for growing babies.

While eggs can grow in other places, most often choose fallopian tubes, but other areas that may be found in the ovary, stomach, cervix, or even outside the womb.

None of these areas have the means to grow a baby. When the egg implants in there and start to grow causing bleeding, possible broken areas as the oviduct, and will eventually run may lead to situations that will create the bleeding and put lives at risk mothers. The presence of your period during pregnancy may be one clue that all is not as they appear.

Noting the symptoms that may be present in the ectopic pregnancy is very important, especially if you’ve become a victim of previous ectopic pregnancy. Mothers over the age of 35 at the beginning of pregnancy previously had an ectopic pregnancy or pelvic inflammatory disease ever more vulnerable.

If you are in one high risk group it pays to pay attention to your body signals and to seek good medical advice if you have symptoms of an ectopic pregnancy. If you have periods during pregnancy, shoulder pain, pain in the pelvic area or abdomen, dizziness, nausea or other symptoms does not mean that you had an ectopic pregnancy but it is certainly worth checking out.

Each time pain present throughout pregnancy, not just cramps, sore muscles and other parts of the pregnancy is normal, but pelvic pain or pain during intercourse; need to know why it happened. While some discomfort is common in pregnancy, deep pain during activity or movement is not a normal part of becoming pregnant and should be checked with your doctor.

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Know Your Risk Factors and Ectopic Pregnancy - Two main symptoms is vaginal bleeding and pelvic pain unilateral. This can vary in intensity, depending on how far the pregnancy has progressed. Ectopic pregnancy is very dangerous because it can lead to rupture the tube, along with severe bleeding. In extreme cases, intra-abdominal bleeding can be catastrophic and even fatal for the woman.

Ectopic pregnancy occurs at a rate of about one in 60 pregnancies. Certain risk factors have been found to increase the chances for an ectopic pregnancy. Risk factors are:

* History of severe pelvic infection
* Endometriosis
* Cigarette smoking
* Improve maternal age
* History of infertility
* before surgery on fallopian tubes
* Prior pelvic or abdominal surgery (scar tissue)
* Previous Ectopic Pregnancy

If your doctor suspects that you have an ectopic pregnancy, she will perform certain tests. Your doctor may perform a pelvic examination, check your blood pressure and pulse, perform an ultrasound, and take your blood to check your pregnancy hormone levels.

Diagnosis may not appear immediately. Sometimes it may take several days of observation and additional tests before the diagnosis are clear. The use of sophisticated technologies and accurate monitoring of hormonal ultrasound has now been possible to detect the majority of ectopic pregnancies when they were still in the very early stages.

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