In some circumstances, patients wish to proceed directly with amniocentesis, rather than undergo screening. This process is not insured in BC, however, in many countries, it is insured to have amniocentesis on demand. With amniocentesis, a doctor uses ultrasound guidance to place a very thin needle into the uterus. A small sample of fluid from around the baby is taken and sent for chromosome analysis. Amniocentesis is almost 100% in its ability to detect major chromosomal defects, but has with it a small risk (1/100 to 1/200) of inducing miscarriage.
Because of the risk of testing, many women prefer screening as a first step. In British Columbia, there currently are several ways to screen for problems, including First Trimester Screening (FTS), Serum Integrated Pregnancy Screening (SIPS), Integrated Pregnancy Screening (IPS), and Quadruple Screening (Quad). For women younger than 40, an abnormal screen result would qualify them for MSP-insured amniocentesis. Some women, regardless of their screening results, still prefer to have definitive information. Amniocentesis provides diagnostic certainty.
There are conflicting opinions throughout the world regarding the provision of amniocentesis. PCRM’s philosophy follows the American College of Obstetricians and Gynecologists, that the decision to test, to screen, or to do nothing should be the woman’s alone. Based upon this ethical principle of autonomy, if any woman wishes to have diagnostic testing in her pregnancy, she should be allowed to have it.
If you are interested in amniocentesis, please call us at PCRM to speak with our genetic counselor, Ursula Durland, who will help you make an informed decision regarding whether or not to pursue screening or diagnostic testing. Regardless of a woman’s age, amniocentesis is a non-insured service at PCRM. The cost of private amniocentesis at PCRM is $1500.
What to Expect?
The procedure will be scheduled between 15 and 20 weeks. A brief genetic counseling session will precede the amniocentesis; this will give you a chance to ask all of your questions and give your consent. The time needed to do the amniocentesis is short, about 3-4 minutes. You should take the afternoon off to rest. It is common to have some mild cramping or soreness but most women tolerate amniocentesis without complaint. It is done while awake, without sedation. The sample is sent to Integrated Genetics; results are available within 7 days.