Question 34

Severe infection following invasive prenatal diagnosis is rare, but the appearance of cloudy or purulent amniotic fluid should raise concern for infection. RCOG advises consideration of microbiological investigation and antibiotic treatment when such fluid is encountered. Standard preventive measures include sterile skin preparation, sterile ultrasound gel, a sterile probe cover and continuous ultrasound guidance. Simply discarding the sample or offering routine review would fail to address a potentially serious maternal and fetal infection. Immediate delivery is not automatically indicated solely because the fluid is abnormal; management should be guided by appropriate clinical and microbiological assessment.

A) Cloudy or purulent fluid requires assessment for possible infection.

B) Immediate repeat sampling through the same site does not address the infection concern.

C) Routine delayed review is inappropriate when infection may be present.

D) Corticosteroids alone do not treat suspected infection.

E) Genetic testing alone does not investigate possible infection.

G) Immediate delivery is not automatically required solely because the fluid appears abnormal.

H) Cloudy or purulent amniotic fluid should not be regarded as normal.

Navaratnam K, Alfirevic Z; Royal College of Obstetricians and Gynaecologists. Amniocentesis and chorionic villus sampling: Green-top Guideline No. 8. BJOG 2022;129:e1-e15. doi:10.1111/1471-0528.16821.