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boston bean Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 07:49 PM
Original message
How are they gonna get the amniotic fluid?
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China_cat Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 07:49 PM
Response to Original message
1. Amniocentesis will now become a mandatory test.
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Beaverhausen Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 07:51 PM
Response to Reply #1
4. But isn't that test somewhat dangerous?
I had thought it was unless they have made it safer recently.
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laundry_queen Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 07:52 PM
Original message
Yes it is.
Something like a 1% risk of miscarriage after. I've read 2 stories online about losses or extremely premature babies because of the membranes rupturing after an amnio.
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moc Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 07:56 PM
Response to Original message
8. Overall risk m/c after amnio is 1/200. Lower risk at facilities
that do many procedures.
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FedUpWithIt All Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 07:57 PM
Response to Original message
10. See my post below.
To break the water of a progressively laboring woman a Dr. uses an instrument that loosely resembles a crochet hook. It is a simple matter to harvest amniotic fluid (it would require no more invasiveness than would commonly occure in labor) prior to breaking the amniotic sac of a woman IN labor.

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China_cat Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:04 PM
Response to Reply #4
14. It has risks of causing miscarriage
and used to carry the risk of puncturing the placenta, causing an abruption. With better scanning technology, though, that risk has because as close to nil as you can get.

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boston bean Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 07:51 PM
Response to Reply #1
5. do you think this is why the say all babies should be tested for down's
I have been wondering if the testing for all babies and moms will be done through the blood testing or amnioscentesis.
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moc Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:03 PM
Response to Reply #5
13. Sorry, it's not happening (m)
They may say they want to do 100% screening (i.e., the blood tests) although those have horribly high false positive rates.

No one is going to force pregnant women to have amnios. That's just silly. Now, I've heard of isolated instances in which an OB refuses to provide care for an AMA (woman of advanced maternal age; i.e., >35) if she declined an amnio, but that's not the same thing.
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boston bean Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:06 PM
Response to Reply #13
17. so it is just the blood tests then? good, I was wondering why they
might put all those women and babies at risk unnecessarily.

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moc Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:16 PM
Response to Reply #17
29. Do you want my cynical response?
Edited on Mon Jan-08-07 08:18 PM by moc
From a population stand point, the false positive rate is not that great. That is, the added burden of amnios for no reason would not adversely impact payers. That's why, imo, the FPR's reported by the industry are based on dividing the # of false positives by the total number of women screened rather than dividing it by the number of screen positives. (The latter is the true definition of the false positive rate.) So, when the industry folks claim the FPR is 5%, it means that out of any population of women they screen, they will be doing an amnio on 5% of them unnecessarily. No big deal, eh? Well, look at it from a woman's perspective. She gets a screen result that is "bad". She totally freaks out and struggles with whether she should do an amnio. Her physician (who more than likely has no idea how FPRs are calculated) tells her the FPR is 5%. Woman assumes that means she has a 95% chance of having a Down's baby, so she opts for an amnio. However, that's wrong. If she had a 2nd trimester screen and she's young (i.e., less than 35, the FPR is >99%. That is, out of every 1000 women who get a "bad" screen test result, 995 of them will be carrying a non-trisomy 21 fetus.

But, the genetic screeners get to do more amnios and the insurance pays. Everyone's a winner except the pregnant woman.

Sorry to rant. It's a pet peeve of mine.
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boston bean Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 09:08 PM
Response to Reply #29
37. What you are saying is very true and good reason for amnios not to be
done.

It is very harsh on the mother. Most mothers I know would avoid a needle to collect amniotic fluid. It is a risk that is not necessary.
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Bunny Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 07:50 PM
Response to Original message
2. Have pregnant women squat over a bucket when their water is
about to break? :shrug:
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FedUpWithIt All Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 07:50 PM
Response to Original message
3. Amniotic fluid can be needle extracted cleanly
just prior to delivery.

It is routine for a Dr. to break the amniotic sac of a pregnant woman in progressive labor.
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YDogg Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 07:54 PM
Response to Reply #3
7. this'll spice up "Baby Story" on TLC
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boston bean Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 07:58 PM
Response to Reply #7
11. LOL
:rofl:
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boston bean Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 07:56 PM
Response to Reply #3
9. Um the last thing I would want is a long needle sucking out my
amniotic fluid through my vagina just prior to birth. Thanks but no thanks. What if it hits the babies head. There are enough risks with childbirth.
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FedUpWithIt All Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:05 PM
Response to Reply #9
16. Have you ever attended a delivery?
I have attended 9 aside from the birth of my own three. They already "break the water" of the majority of women using a long instrument. One of my children would have died had forceps not been used. It is a wonder children are born alive with such things...:eyes: Not to mention the sharp surgical instruments used to deliver a C-Section. There are many "invasive" processes that go along with childbirth. A needle breaking an amniotic sac would be one of the least invasive.

It is clear from your post that no matter what argument is made in favor of this method of harvesting stem cells, you would disagree with it...Noted.

I personally would allow a needle to be inserted into the amniotic sac of a pregnancy that i was near delivered of if it offered further opportunity for study and possible curing of many diseases.

But then..that's just me.
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boston bean Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:09 PM
Response to Reply #16
22. I don't disagree with it. I am just wondering how they gonna obtain
all the amniotic fluid.

It does seem to have risks and I don't think there is a medical procedure that exists that you are describing.

Oh and by the way I had a full forcep delivery, so I know what you're talking about. It almost killed me.
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FedUpWithIt All Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:13 PM
Response to Reply #22
25. What medical procedure doesn't exist?
they have been harvesting core blood using a similar method for some time now. I have explained that i have witnessed and have had myself the breaking of the amniotic sac. It is an amniocentesis done at the point of delivery so as not to have the risk factors of premature delivery or infection.

:shrug:
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boston bean Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:15 PM
Response to Reply #25
26. My water was broke as well in the hospital, It was a long crochet hook
not a freakin needle.

And it was a quick movement not a needle having to be in the exact righ spot for a period of time.

There must be risks with what you have described.

Give me an article explaining the procedure of which you speak.
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FedUpWithIt All Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:34 PM
Response to Reply #26
35. One of the deliveries i attended was being monitored for a study...
Edited on Mon Jan-08-07 08:39 PM by FedUpWithIt All
a clean sample of amniotic fluid had to be collected. Two methods were used. An extraction and a drain collection.


Although i do not have site permission the article at this site mentions the techniques used to collect a clean amniotic sample during delivery.

As per google...

A"t this centre amniotic fluid is routinely. collected. per. vaginarn at surgical induction of. labour in order to collect data on the correlation ..."

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1471-0528.1974.tb00458.x

I have seen this done and it was not at all traumatic to either the mother or child.

Edited for spelling
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NashVegas Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 07:52 PM
Response to Original message
6. I Get Your Point
More and more, I'm reminded of Steven King's The Tommyknockers when it comes to what we're doing to ourselves.
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Teacher in SC Donating Member (100 posts) Send PM | Profile | Ignore Mon Jan-08-07 07:59 PM
Response to Original message
12. Obtaining amniotic fluid
It is fairly routine for women over 35 to have amniocentesis, so I would imagine as they are extracting fluid in the syringe some could be used for the test and the rest for these new ideas.

I have read recently that there are new tests that don't involve amnio to check for downs syndrome and other genetic phenomena. This may reduce the number of women going for the amnio test. I don't know.

"Is there a doctor in the house" who can enlighten us?
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boston bean Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:04 PM
Response to Reply #12
15. But if there are risks and an amnio is obtained and the risks turn out
to become true, the baby has downs, and then the mother decides to have an abortion, then wouldn't these cells be part of the poisonous fruit.

How can you obtain stem cells from women who will most likely terminate their pregnancy.

Besides the fact that science probably wouldn't use them anyway.
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Teacher in SC Donating Member (100 posts) Send PM | Profile | Ignore Mon Jan-08-07 08:11 PM
Response to Reply #15
23. amnio test
The article I was reading indicated that more women who are younger have babies with downs syndrome statistically, so all women should have the test they were talking about first (not amnio right away). The question is, how would a scientist know if they had a "clear" specimen of fluid to use no matter who they took it from?
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moc Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:09 PM
Response to Reply #12
20. I'm not that kind of doctor, but FWIW
The tests you're referring to are screeners - blood tests. Ones in the 2nd trimester are blood tests only. The 1st trimester screener combines a blood test with a sonographic measurement of nuchal fold (neck skin). Both tests have very high false positive rates - >98% for the 2nd trimester and >94% for the 1st trimester. Keep in mind that the FPR is defined as the number of false positives divided by the screen positives. (You'll see lower false positive rates reported in the literature, but they are defining the FPR using a different demonimator, specifically the total number of women screened. It makes no sense epidemiologically why they do that - well it does if you're just concerned about impacts on providers and not women.)

You can also dx downs via CVS - chorionic villa sampling. It's invasive in the same way that amnio is except that the sample is extracted through the sample, and it's a sample of the chorionic villa not the amniotic fluid. It can be done during the first trimester. It has a higher complications rate than amnio though.

Hope this helps.
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Teacher in SC Donating Member (100 posts) Send PM | Profile | Ignore Mon Jan-08-07 08:15 PM
Response to Reply #20
27. Thanks, moc (doc)!
Very enlightening, but sure is disappointing to hear that what I had thought was something innovative and useful for mothers to be of any age is not all that reliable.
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moc Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:17 PM
Response to Reply #27
30. My pleasure, and welcome to DU!
:toast:
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Teacher in SC Donating Member (100 posts) Send PM | Profile | Ignore Mon Jan-08-07 08:23 PM
Response to Reply #30
33. Thanks.
:hi: I'm addicted to this forum!
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HiFructosePronSyrup Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:06 PM
Response to Original message
18. They're not.
This is just a piss poor attempt to stop stem cell research. They don't care about amniotic fluid, or babies, or mothers, or sick people.
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FedUpWithIt All Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:09 PM
Response to Original message
19. Wow...just wow.
:shrug:

Sometimes i swear it is like i walked onto another site. One that discounts information in an effort to push forward an agenda.

I am going to slink back off to my world of reality and fair handedness now. :::sigh:::
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annabanana Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:09 PM
Response to Original message
21. I had amniocentesis. . (being an "older" incipient Mom)
It was pretty uncomfortable (big needle in the belly, and all) and it can induce a miscarriage. Not the sort of thing that should be imposed. The results of testing the fluid can be very useful though, which is why it can be worth it.
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boston bean Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:12 PM
Response to Reply #21
24. I agree with. It is a good thing, but most women have it for
reasons so they can make decisions.

How in the world is this ok with the right wingers?
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FedUpWithIt All Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:17 PM
Response to Reply #21
31. Amniocentesis is NOT necessary in the form being discussed here.
the needle would be inserted into the bulging and ready to break tissue of the amniotic sac of a vaginally presenting woman in progressive labor. One would not even realize it was being done except in the instance where the needle would break the fluid sac, which would only spare the patient from a further procedure to break it.

There would be no premature labor or infection risk as the labor would already be progressive. There would also be no abdominal puncture.
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Teacher in SC Donating Member (100 posts) Send PM | Profile | Ignore Mon Jan-08-07 08:31 PM
Response to Reply #31
34. That's much better
That makes a lot of sense and eliminates a lot of the problems. I'm still wondering how scientists can be sure they have a clear draw that has "normal" cells to use for research.
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FedUpWithIt All Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:36 PM
Response to Reply #34
36. I would assume with any sample collection there is a risk of contamination...
this would be no different i suspect. Out of many a few will be clean.

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Sydnie Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:16 PM
Response to Original message
28. When I was pregnant with my oldest (19 now)
I had begged the hospital to "harvest" my fluid. At the time, it was growth hormone that could be extracted back then. They looked at me like I had three heads. As fate had it, my water broke at home for that child and made my anger at their lack of interest in my fluid a non-issue. That was not the case with the second one. My water bag had to be broken in the hospital as she was pushing her way out, intact bag and all! They had no program to accept such a donation then either and this is at a hospital that is primarily devoted to childbirth and infant care.

I bet they have considered it more fully now though.
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Beaverhausen Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 08:20 PM
Response to Original message
32. I get the feeling some on this thread aren't aware of the news about stem cells...
...being able to be harvested from Amniotic fluid.

I myself hadn't thought about collecting it at the time of delivery - I was just thinking about the test done during the second trimester to test the fetus for birth defects.
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boston bean Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-08-07 09:12 PM
Response to Reply #32
38. but, but, but, don't the christian right want people to have no choice
isn't an amnio test giving women a basis to make a decision and choice?

How can they have it both ways.

Don't get me wrong. If there is a safe way with out unwarranted risks to obtain the fluid, I am all for it. But I think it might be a red herring to stop the work with with embryonic stem cells. As I understand now, there is a difference between the two.

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