Speciality
Spotlight

 




 


Obstetric & Gynaecology


 

 




Fetus-Placenta-Newborn

   

  • Eduard Gratacos, Roland Devlieger, et al (Univ Hospital Gasthuisberg, Leuven and the Instituto Ostetrico ginecologico, Milano, Italy)


    Is the angle of needle insertion influencing the created defect in human fetal membranes ? Evaluation of the agreement between specialists’ opinions and ex vivo observations.



    Am J Obstet Gynecol, 182(3), March 2000, pg. 646-9.


        

    Objective: Recent data from prospective clinical trials in large numbers of patients report figures of 2.4%. Although amnion leak spontaneously disappears in many cases, these women normally have a poorer pregnancy outcome. The authors sought to evaluate the agreement between the opinions of specialists in fetal medicine with ex-vivo observations on the potential influence of the angle of needle insertion on the fluid leak through the created defect in human fetal membranes.

       


    Study Design: Membranes from placentas of women who were delivered by elective cesarean were harvested, cut in pieces, and secured to the bottom of plastic tubes filled with Hartman solution. They were punctured with 18-, 20-, or 22-guage needles, with an angle of insertion of 90 (group1) or 45 (group 2), and the flow rate (in milliliters per minute) though the created defect at a constant pressure of 150mm H20 was measured. Fifty physicians performing amniocentesis at fetal medicine reference centers were interviewed about their impression and clinical attitude with respect to the angle of needle insertion at the time of amniocentesis.

       


    Results: In the ex-vivo study, puncture with a 45 angle was associated with a significantly lower flow of fluid through the membrane defect for all needle sizes tested. Regarding survey answers, 82% of physicians try to perform amniocentesis with a given angle (i.e. 90 in the vast majority of cases). Among the reasons for doing so, minimizing membrane damage was mentioned in more than half of cases.

       

    Conclusion: These results provide evidence that the angle of needle insertion influences the type of defect and therefore the flow rate through human membranes. Membrane damage is a concern of a proportion of specialists while performing amniocentesis, but ex vivo observations do not agree with clinical assumptions on the potential influence of the angle of insertion.

        

      



 

 

Speciality Spotlight

 

 

Fetus-Placenta-Newborn
   

  • Eduard Gratacos, Roland Devlieger, et al (Univ Hospital Gasthuisberg, Leuven and the Instituto Ostetrico ginecologico, Milano, Italy)
    Is the angle of needle insertion influencing the created defect in human fetal membranes ? Evaluation of the agreement between specialists’ opinions and ex vivo observations.
    Am J Obstet Gynecol, 182(3), March 2000, pg. 646-9.
        
    Objective: Recent data from prospective clinical trials in large numbers of patients report figures of 2.4%. Although amnion leak spontaneously disappears in many cases, these women normally have a poorer pregnancy outcome. The authors sought to evaluate the agreement between the opinions of specialists in fetal medicine with ex-vivo observations on the potential influence of the angle of needle insertion on the fluid leak through the created defect in human fetal membranes.
       
    Study Design: Membranes from placentas of women who were delivered by elective cesarean were harvested, cut in pieces, and secured to the bottom of plastic tubes filled with Hartman solution. They were punctured with 18-, 20-, or 22-guage needles, with an angle of insertion of 90 (group1) or 45 (group 2), and the flow rate (in milliliters per minute) though the created defect at a constant pressure of 150mm H20 was measured. Fifty physicians performing amniocentesis at fetal medicine reference centers were interviewed about their impression and clinical attitude with respect to the angle of needle insertion at the time of amniocentesis.
       
    Results: In the ex-vivo study, puncture with a 45 angle was associated with a significantly lower flow of fluid through the membrane defect for all needle sizes tested. Regarding survey answers, 82% of physicians try to perform amniocentesis with a given angle (i.e. 90 in the vast majority of cases). Among the reasons for doing so, minimizing membrane damage was mentioned in more than half of cases.
       
    Conclusion: These results provide evidence that the angle of needle insertion influences the type of defect and therefore the flow rate through human membranes. Membrane damage is a concern of a proportion of specialists while performing amniocentesis, but ex vivo observations do not agree with clinical assumptions on the potential influence of the angle of insertion.
        

      

 

By |2022-07-20T16:43:05+00:00July 20, 2022|Uncategorized|Comments Off on Fetus-Placenta-Newborn

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