Can a selective use of amniocentesis replace the routine procedure for advanced maternal age?

Objective: Retrospective evaluation of the significance of selected use of amniocentesis in 35-year-old pregnant women and older. Materials and methods: The study population included 35-year-old pregnant women and older, who underwent amniocentesis and were divided into three groups. The first group consisted of 4838 women who underwent amniocentesis because of their advanced maternal age (AMA); the second group consisted of 627 women who underwent the triple test before amniocentesis; the third group consisted of 99 women who asked the combined test before amniocentesis. Results: In 35-year-old women and older who underwent the triple test and the combined test both cases of Down syndrome and other chromosome abnormalities were detected. It was possible to reduce the number of amniocenteses by about 80% without false negatives. Conclusions: Amniocentesis may be performed on a selective rather than routine basis in 35-year-old women and older according to the results of non-invasive screening tests. The combined test proved better than the second trimester triple test (p=0.0046), and both reduced the number of amniocenteses by about 80%, while every case of Down syndrome was successfully diagnosed.