24.    A 36-year-old woman in her 10th week of pregnancy was advised to go for an amniocentesis. The karyotype report suggests a male fetus with trisomy 21. 

a)        What is the risk of miscarriage associated with an amniocentesis procedure?

           1:100.

b)         List four other complications following amniocentesis.

            1.    Oligohydramnios.

             2.    Amniotic bands.

             3.    Talipes.

             4.    Congenital dislocation of the hip.

             5.    Rhesus immunization.

             6.    Neonatal respiratory distress syndrome.

             7.    Antepartum hemorrhage.

c)         What is an alternative procedure to amniocentesis which yields a quicker cell culture for karyotyping?

             Chorionic villus sampling.  

d)         What intervention should be discussed in this case? 

            Termination of pregnancy.

e)         List three medical methods which may be used to performed this intervention.

             1.    Intra-amniotic prostaglandin F2.

             2.    Extra-amniotic prostaglandin E2.

             3.    Vaginal prostaglandin analogue / gemeprost.