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Maternal mortality following diagnostic 2nd-trimester amniocentesis
Uriel Elchalal1, Inbar Ben Shachar, Dan Peleg
1Department of Obstetrics and Gynecology, Hadassah University Hospital, Eim-Kerem, Hebrew University, Jerusalem, Israel. elchalal@cc.huji.ac.il
Fetal Diagnosis and Therapy
|February 7, 2004
Summary
Transabdominal amniocentesis, a second-trimester procedure, can lead to rare but life-threatening maternal deaths from Escherichia coli sepsis. Early recognition of fever and leukopenia post-procedure is crucial for prompt intervention.
Area of Science:
- Obstetrics and Gynecology
- Maternal Fetal Medicine
- Infectious Diseases
Background:
- Transabdominal amniocentesis is a common second-trimester prenatal diagnostic procedure.
- While generally safe, potential maternal complications, though rare, require careful consideration.
Observation:
- Two cases of maternal mortality following transabdominal amniocentesis during the second trimester are presented.
- Both cases involved sepsis caused by Escherichia coli, identified via blood cultures.
Findings:
- Immediate broad-spectrum intravenous antibiotic treatment did not halt the rapid progression of the infection.
- Despite prompt uterine evacuation and intensive care for multiorgan failure, both patients succumbed to septic shock.
Implications:
- Septic abortion and shock post-amniocentesis are rare but carry significant maternal mortality risk.
- Physicians should be vigilant for fever and leukopenia days after amniocentesis, indicative of evolving sepsis.
- Informed consent must include the remote possibility of severe maternal risks alongside fetal complications.