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What An Amnio is Like February 1, 2008

Filed under: ?Baby? — booksunread @ 1:04 pm

I thought I would write about a post about what having the amnio was like for those out there wanting the less clinical, book description.

My amnio was performed by a perinatalogist outside of my OBs office, who practices at several other facilities around the city.  The NMW at my practice said they had been using him for a while, and he had performed her own amnio. And she’d never clinically seen a miscarriage caused by an amnio.  So this doc has a pretty good track record, I figured…not that I would have thought to ask if I had a choice in who I was going to see.  This was stupid, but indicative of the blindly follow medical model we have going in this country.  I’d advise anyone staring down the barrel of an amnio to ask questions about the practitioner performing it. How long as your doc’s office worked with them? How many amnios have they done? What is their track record for bad outcomes, etc.

In order to get in as quickly as possible, we were sent to the downtown hospital’s perinatal center.  Not only was this much farther from home, it meant we got to drive by the city’s planned parenthood, complete with protester signs of dead babies for an entire block. 

Miguel drove me, mostly so I could relax and let him do the longish drive on the way home.  I didn’t want him to come back with me for several reasons. At first, I thought he might like to see the ultrasound, his first since it was a tiny ball of cells with a heartbeat, but then I figured, if things go bad, why torture him with that.  Secondly, he does poorly with needles, he doesn’t even have a very good track record for giving his own blood.  I’ve read that the amnio needle is looong and just didn’t think he could handle it.  Third, he deals badly and aggressively with stressful medical situations and I just figured he’d be all up in the doctor’s grill asking him for reassurances that he can’t give.

So he was relegated to the waiting room.  Where as expected, we waited. Because they were running 45 minutes late. Typical and expected but seriously, I have yet to go to any doctor’s office where they run on time.  Why is it so hard to set an appointment and keep it? If you’re having trouble staying on time, space out your appointments more, wouldn’t you think?

Because I had my amnio at just past 15 weeks, which is on the early side, they wanted me to get plenty of fluid and put my feet up as much as possible to make sure there was enough fluid to do the test.  I drank about of gallon of water each of the days leading up to the test and left work early to go home and rest with my feet up.  I drank a good bit that morning too.  By that point my bladder physically hurt from stretching it out so much with all that water.

The amnio started with just me and the ultrasound tech who took a look around and made various measurements.  Then the perinatalogist came in and took a closer look around; they put in color to look at the four chambers of the heart closely to make sure it was pumping correctly and also to see where the cord was.  They looked around to determine where the biggest pocket of amniotic fluid was that was as far away from the baby, the cord and placenta as possible to reduce the risk of hitting any of these things with the amnio needle.  They also took a heart rate on the baby to compare to after the amnio.

As usual, wee baby was quite bumpy and jumpy around in there, which scared the holy hell out of me in terms of worrying the baby would bump itself into the needle while it was in there.  The doctor then explained that there is a risk of miscarriage, and for legal reasons, they quote the national statistic of 1 in 200. However, he said that included people who didn’t use ultrasound to guide the needle, who didn’t have as good ultrasound technology, or who didn’t observe sterile procedures and introduced infection.  He said that the way that they do it reduces the risk greatly. So that’s my second and third pieces of advice to anyone out there planning an amnio-make sure they use ultrasound and confirm beforehand they have the ability to do “flows” (add color to see where the cord is), and make sure they observe sterile procedures (my experience outlined below).  And speak up during it if something seems not sterile; I just read an article somewhere about how a LOT of healthcare workers neglect to wash between patients when doing routine tasks like vitals and IVs and urges people to take it into their own hands to ask medical personnel to wash if needed.

All of the equipment used came from a sterile tray.  The doctor washed his hands and donned sterile gloves before opening the tray.  I had my pants rolled down and top pulled up and towels were tucked into both. My belly was swabbed liberally with bactine and blotted dry with a sterile drape.  I was instructed to put my hands up behind my neck to get them out of the way of the sterile field.  The ultrasound tech also put on a fresh glove at this time, and put fresh gel from the regular bottle on the wand.  Then, they rolled a plastic sleeve from the sterile kit over the wand.  The doctor used a little packet of sterile gel from the tray to put directly on my belly. 

I could not tell you how long or big the amnio needle was, because this was right about the point where I stopped looking.  First, the doctor gave me shot of local anesthetic, which pinched and burned a little bit.  Then the amnio needle went in and I most definitely felt a weird cramping sensation on the right side of my very lower groin, almost where the thigh and crotch meet. I wanted to convulse, but tried to hold as still as possible.  Like when they take blood, they collect it in little vials, and because we opted for the rapid results test, they needed to collect multiple vials, so there was a break in the action as with the needle still in me, he switched out the collection vials.  Towards the end, he was gently pushing on my stomach and asking the ultrasound tech to do the same with the wand to squeeze a little bit more fluid out, I guess.  After the needle was out, they did a heart rate check again. Mine was 129 which was a little slow, but still in the okay range.  The doctor made it a point to show me that the fluid was clear-meaning that they hadn’t hit any blood vessels or anything on me or the baby.  The vials were amber, so I couldn’t really tell if it was clear or not, but I took his word for it.

Then they cleaned me up and gave me an extra wet washcloth to dig around in my belly button to get all the bactine out so it wouldn’t stain my clothes.  And then I was free to get up and leave.  I felt a little sore down on that right side groin/thigh area and just generally a little nauseous with anxiety over the whole thing.  I walked gingerly out to the waiting room and Miguel took me home. 

On the way, Miguel expressed disbelief that they had not even given me a bandaid to cover the hole.  “What if you spring a leak?!?”  I derisively explained that it was just a little needle stick, I guess it wasn’t even bleeding, and fluid would not seep up from my uterus through that tiny hole in all that tissue and muscle to my stomach.  If it was going to leak, it would leak into my uterus and then show up as spotting.  Little did I know.  The after care instructions were to go home and rest for 24 hours, and to watch for fever, severe bleeding and cramping (light spotting and mild cramping could be expected). 

I went home, Miguel went back to work, and I settled myself upstairs with a sippy cup to replenish lost fluid.  Before I went to bed, I went to the bathroom, and almost had a heart attack when the front waistband of my panties was wet with something clear and something dark.  At first I figured that some of the wet washcloth and bactine mixture had seeped past the protective towel and wet it.  Closer inspection revealed the dark spots to be blood.  Further investigation revealed that right where my waistband hit, just at the top of my pubic hair, two needles marks where the local and amnio needles had gone in.  It appeared that I had sprung a leak-and not just blood since there was also a lot of clear wetness on the underwear band, too.  If it had not required me to go back downstairs, to fetch the number, I would have called the doctor’s office to see if this was normal.  However, I was trying to move as little as possible and get horizontal as quickly as possible to let things close up asap.  Frankly, I was afraid to sneeze at this point, let alone trot up and downstairs.  There didn’t seem to be anything leaking now; I tucked a kleenex over it to make sure and laid down. 

Except to go down for meals and go to the bathroom, I stayed in bed the entire 24 hour rest period (and maybe an hour or two beyond).  Miguel was in charge of fetching food and water and anything else I wanted.  I anxiously checked for anything out of the ordinary leaking and started at every twinge, convinced it would soon turn into a cramp.  I still felt a little weird down that right leg and was convinced a bloodclot or embolism was traveling down my leg.  It was only a matter of time until it went to my heart and killed me.

Which might have been preferable to the level of emotional stress and anxiety steadily mounting since late yesterday afternoon, waiting on my test results.  We opted for the rapid 48 hour results (known as FISH). Unfortunately, when my results didn’t come in Monday, they investigated and found out that the lab had fucked up royally and did not run the rapid results-just the regular panel that takes a week.  They tried to correct it by running the FISH now, but there is a very good chance it may not work because of the delay.  Livid and emotionally wrung out do not even begin to cover my feelings on possibly having to wait until Friday for results. Fortunately, the FISH worked and was valid, even with the delay.  The FISH results do tell us that the main thing we were worried about-Downs, is negative, but there are several smaller chromosomal abnormalities that you don’t get results for until the full panel.  So we are 99% out of the woods. I won’t fully relax until we get the full panel all clear today.


2 Responses to “What An Amnio is Like”

  1. TwinMommy Says:

    Wow! Your post is proof that I made the right decision 🙂
    When my first OB came after me offering all the tests for Downs, etc my immediate answer was “No thanks!” My husband did not feel the same way, he wanted to do all tests available so we’d know what to expect. It took a week but I convinced him that we should pass on the tests. My reaction was so quick because we’d already lost one baby and I wasn’t about to lose another if something might be wrong with it. I guess I’m like your husband with the needles too…I couldn’t imagine a huge needle in my tummy…you were so brave to agree to that. I’m glad everything came back well and I hear you on the blogging. Peeps tend to worry when they don’t see a post on my twinsite but sometimes I just can’t bring myself to write. Fingers crossed that you have a normal happy pregnancy and don’t end up on bedrest like me- ughhh! My mother said she was up on a ladder painting when she was 8mths preggo with me…she looooved being preggo!

  2. booksunread Says:

    It was definitely a hard decision to make to decide on the ultrascreen, again sort of why tempt fate, but once we had reason to believe there was something potentially wrong, there was no question we’d do the amnio to know for sure.

    One thing that I thought was interesting is all the books present amnio and CVS as comparable options and from the actual test standpoint, the CVS sounded better to me (for those who don’t know, basically they go up through your vagina, rather than in through your stomach and pinch off some tissue rather than suck out fluid). Using the holes available seemed far more attractive to me than making new ones. However, when I asked about it, the NMW said that there are only three practioners who even do it in our area (and I live around Cincinnati, OH-it’s not John’s Hopkins or the Mayo Clinic but it’s not the boondocks either). Just kind of strange, I wonder why that is…
    Anyway, alls well that ends well. I am also hoping I don’t end up on bedrest. Our downstairs cable box was actually blown up that weekend so I had to stay up in bed that whole time and Sunday morning (if I wanted to watch TV) and I was getting kind of sick of it…so I feel your pain twinmommy! Still bedrest at home sounds bunches better than bed”rest” at the hospital. Hope you can stay on the lam for as long as possible! 🙂

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