By Dr. Michael Peters
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AFP can be measured in the maternal blood from the latter part of the first trimester of pregnancy, and its concentration rises between the 15th and 20th weeks. Raised levels of AFP are associated with fetal neural tube defects, such as spina bifida or anencephaly, and certain kidney abnormalities. High levels of AFP also occur in multiple pregnancies (see pregnancy, multiple) and threatened or actual miscarriage. AFP levels may be unusually low if the fetus has Down’s syndrome. For this reason, measurement of blood AFP is included in blood tests that are used to screen pregnant women for increased risk of Down’s syndrome.
The severity of rhesus incompatibility and the maturity of the fetal lungs can also be checked by amniocentesis. HOW IT IS DONE Amniocentesis is usually performed in the 14th to 18th week of pregnancy. It may be performed earlier, but this is technically more difficult a this early stage. The skin of the abdomen is cleaned and a needle is inserted into the amniotic sac; (in all cases, ultrasound scanning is used to avoid contact with the fetus and placenta). An attached syringe removes some fluid for analysis.
RECOVERY AND OUTLOOK The stump is usually swollen for about six weeks after the operation. For some time after amputation, there may also be an unpleasant sensation that the limb is still present. This phenomenon is known as “phantom limb”. A prosthesis will usually be fitted, if necessary, once the stump has healed and the swelling has gone down. amputation, congenital The separation of a body part (usually a limb, finger, or toe) from the rest of the body, as a result of the blood supply to the part being blocked, in the uterus, by a band of amnion (fetal membrane).