A Narrative Review: Maternal Comorbidities and Amniocentesis-Related Complications

Objective: To evaluate whether common maternal conditions—such as vaginitis, infection, gestational diabetes mellitus (GDM), hypertensive disorders, hepatitis B virus (HBV) infection, Rh-negative pregnancy, and the use of low-molecular-weight heparin (LMWH)—influence the safety or outcomes of amniocentesis, and to provide practical recommendations to optimize maternal and fetal safety. Mechanism: Amniocentesis is the most widely used invasive prenatal diagnostic procedure worldwide. It involves inserting via a transabdominal approach to obtain fetal samples, including cells, metabolites, urine, or secretions, from the amniotic fluid. Complications include premature rupture of membranes (PROM), infection, spontaneous miscarriage, and pregnancy loss, although their overall incidence is <1%. Although most studies have focused on procedure-related risks for pregnancy outcomes, the impact of maternal conditions on these outcomes has been less systematically evaluated. Findings in Brief: This review found no solid evidence that maternal vaginitis, infection, GDM, hypertensive disorders, or HBV infection increase the risk of adverse outcomes following amniocentesis. Similarly, available data suggest that the use of LMWH does not significantly increase the risk of bleeding when appropriately. Conclusions: Amniocentesis can generally be performed safely when maternal disorders are in a relatively stable phase. For Rh-negative women, anti-D immunoglobulin should be administered prior to invasive testing to reduce the risk of alloimmunization. For pregnant women receiving prophylactic LMWH, discontinuation 24 hours before the procedure is recommended; while routine anti-Xa monitoring is not required except in cases of severe renal insufficiency. Although based on limited evidence, these recommendations aim to minimize procedure-related complications and optimize maternal and fetal safety.