Figure 3: Total resolution of the previous findings shown on Fig
2. A normal -appearing fetal neck was observed three weeks later.
Most researchers have concluded that fetal puncture during amniocentesis rarely occurs, and when it does it is of little or no significance9,14. Most fetal injuries occur during amniocentesis performed in late the 2nd and 3rd trimesters of pregnancy. Petrikovsky and Kaplan15 reported a 0.4 incidence of inadvertent contact between the needle and fetal parts during genetic amniocentesis performed under constant sonographic guidance. Fetal feet and hands were involved in the needle contact more often than fetal head, chest or abdomen.
The immediate response of the fetus consisted of brisk withdrawal of the "involvedâ€ small part. None of the newborns exhibited needle marks upon delivery.
More serious complications occur when the fetal head, chest, abdomen or umbilical cord become the targets of inadvertent needle injury. The current case involved a vascular injury of the fetal neck during amniocentesis. Serial ultrasound examinations allowed us to observe an in utero healing process including complete resolution of a large neck hematoma.
Inadvertent contact between an amniocentesis needle and fetal parts occurs infrequently. Serious complications occur mostly during late 2nd and 3rd trimester amniocentesis and may cause fetal demise or serious injury. Continuous ultrasound guidance during the procedure, as judged by our experience, cannot guarantee the absolute safety of the fetus; however, simultaneous sonographic guidance is probably responsible for the occurrence of serious fetal injuries as most cases of fetal injuries, were reported prior to its widespread use. There is no apparent association between the needle gauge and the occurrence of severe fetal injury. Fetal vascular injuries rarely occur and may heal spontaneously.
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