Abstract
Diagnostic puncture (amniocentesis, chorionic villus sampling, and fetal blood sampling)
is an essential part of prenatal diagnostics and the only established and sufficiently
scientifically evaluated possibility of diagnosing genetic diseases from pregnancy-specific
cells. The number of diagnostic punctures in Germany, as in other countries, has fallen
significantly. This is largely due to the introduction of first-trimester screening with
further detailed ultrasound examination of the fetus and the analysis of cf-DNA (cell-free
DNA) from maternal blood (noninvasive prenatal test – NIPT). On the other hand, knowledge
about the incidence and appearance of genetic diseases has increased. The development of
modern molecular genetic techniques (microarray and exome analysis) makes a differentiated
investigation of these diseases increasingly possible. The requirements for education and
counseling regarding these complex correlations have thus increased. The studies performed in
recent years make it clear that diagnostic puncture performed in expert centers is associated
with a low risk of complications. In particular, the procedure-related miscarriage risk hardly
differs from the background risk for spontaneous abortion. In 2013, the Section of Gynecology
and Obstetrics of the German Society for Ultrasound in Medicine (DEGUM) published
recommendations on diagnostic puncture in prenatal medicine [1]. The developments described above and new findings in recent years make it necessary
to revise and reformulate these recommendations. The aim of this review is to compile
important and current facts regarding prenatal medical puncture (including technique,
complications, genetic examinations). It is intended to provide basic, comprehensive, and
up-to-date information on diagnostic puncture in prenatal medicine. It replaces the
publication from 2013 [1].
Keywords
amniocentesis - chorionic villus sampling - fetal blood sampling - prenatal ultrasound