Amniocentesis Korean 환자교육태아기진단진료소 양수검사 귀하의검사절차및동의서를이해하도록도움 t 절차상의치료 UH0173 에관한특별동의서 양식을읽고서명하시기전에이안내책자를참조하시기바랍니다. 이안내책자는양수검사에서예상할수있는사항을설명하는책자입니다. 이책자에는

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Korean 환자교육태아기진단진료소 양수검사 귀하의검사절차및동의서를이해하도록도움 t 절차상의치료 UH0173 에관한특별동의서 양식을읽고서명하시기전에이안내책자를참조하시기바랍니다. 이안내책자는양수검사에서예상할수있는사항을설명하는책자입니다. 이책자에는검사의이로운점, 위험성그리고부작용및대안방법등이포함되어있습니다.

앰니오검사는임신 2 기인보통 16 주에서 22 주사이에실시됩니다. 양수검사는어떻게실시되는가? 귀하태아의위치를알고양수검사를가장안전하게실시하는방도를결정하는데우선초음파검사를하게됩니다. 전체적인검사과정동안초음파검사가실시되며검사는 2 분정도걸립니다.

1 Korean 환자교육태아기진단진료소 양수검사 귀하의검사절차및동의서를이해하도록도움 t 절차상의치료 UH0173 에관한특별동의서 양식을읽고서명하시기전에이안내책자를참조하시기바랍니다. 이안내책자는양수검사에서예상할수있는사항을설명하는책자입니다. 이책자에는검사의이로운점, 위험성그리고부작용및대안방법등이포함되어있습니다. 이책자는귀하진료인과의상담외에추가로제공되는안내입니다. 이안내를완전히이해하시는것이매우중요함으로각페이지를신중히읽어주시기바랍니다. 양수검사란무엇인가? 양수검사는 ( 앰 - 니 - 오 - 센 - 티 - 시스 ) 귀하태아의다양한건강문제를검사할수있도록허가하는절차입니다. 이는앰니오라고도불립니다. 앰니오검사는임신 2 기인보통 16 주에서 22 주사이에실시됩니다. 양수검사는어떻게실시되는가? 귀하태아의위치를알고양수검사를가장안전하게실시하는방도를결정하는데우선초음파검사를하게됩니다. 전체적인검사과정동안초음파검사가실시되며검사는 2 분정도걸립니다. 태아를초음파로관찰하며, 의사가가느다란주사바늘을귀하의복부에주입하여성장하고있는태아를둘러싼액체인 2 큰술의양수를추출하게됩니다. 주사바늘은태아를건드리지않습니다. 양수검사절차과정귀하의파트너, 배우자, 친구또는가족들이동참하도록환영합니다. 대부분의여성들은양수검사에대하여우려합니다. 그러나거의모든여성들이검사를받은후, 생각했던것보다매우빠르고간단하였다고얘기합니다. 어떠한약품이사용되는가? 의사들은양수검사를실시하기전에살균비누를사용하여귀하의복부피부를세척합니다. 만일귀하의혈액이 Rh 음성일경우, 장래임신문제를예방하기위하여양수검사후로감 (RhoGAM) 주사가주입될것입니다.

2 페이지 2 태아기진단진료소양수검사 양수검사로무엇을검사할수있는가? 양수는태아의피부에서떨어진세포를함유하며이는정상적인과정입니다. 이세포들을유전증세일부를진단하는데사용할수있습니다. 태아의염색체가검사되며이는다운증후군및 3염색체성 18등과같은증세를진단할수있습니다. 만일낭포성섬유증혹은근위측증등과같은유전증세가가족중에있을경우, 태아가이와같은질병을전해받았는지알기위하여 DNA 검사를실시할수있습니다. 양수는알파페토프로테인 (AFP) 이라고불리는단백질을함유합니다. 이단백질은태아가만듭니다. 양수에함유된 AFP의양으로척추피열증과같은척추및뇌의선천성결손증을검사합니다. 태아에게염증우려가있을경우, 일부바이러스에대한양수검사를할수있습니다. 귀하의양수검사중추출된샘플검사를완결하는데 3 주까지걸리게됩니다. 양수검사의이로운점은무엇인가? 1. 양수검사는일부건강문제에관하여명백한진단을할수있도록합니다. 일부산모들은태아의건강에관하여확실히알지못하는것보다진단결과를아는것이더낫다고생각합니다. 2. 대부분의경우, 검사결과는정상입니다. 만일귀하태아의건강에관하여염려가되셨다면, 정상적인겸사결과는귀하의임신에대하여안심을하실수있도록도와줍니다. 3. 일부여성들은태아의건강에대하여더많은정보를알수록아기를출산하는데보다더잘준비할수있도록도와준다고믿습니다. 일부여성들은특별한필요성을가진자녀를양육하기를원치않습니다. 진단을받는것은부모들이아기를입양시키거나임신을중절하는등의선택을할수있도록허락합니다. 양수검사의위험성과부작용은무엇인가? 의사들은양수검사절차에대한위험성을가능한낮추도록여러단계를취할것입니다. 그러나어떠한절차도완벽하지는않습니다. 양수검사의주요위험성은자연유산입니다. 자연유산은양수에서염증이시작될경우일어나며혹은절차후태아를둘러싼액낭이치유되지않을경우, 양수가흘러나가도록하여유산을하게됩니다. 양수검사를하지않아도임신 1% 에서 2% 가 (100 중에 1-2) 8 주내지 14 주사이에자연유산하게됩니다. 양수검사를하게되면자연유산위험성이 0.25% (400 중에 1) 추가됩니다. 다른방도로표현하자면, 양수검사를받은 400 여성중 399 여성들이 (99.75%) 자연유산을하지않습니다. 양수검사에는약간의제한성이있습니다 : 다수의건강문제및선천성결손증은양수검사또는어떠한태아기검사로도진단할수없습니다. 정상적인양수검사결과가태아의건강을보장하지는않습니다 ( 이페이지왼편에있는안내를참조하십시오 ). 양수를추출하는것이항상가능하지는않습니다. 가끔, 의사가두번째시도를할수도있습니다. 두번째시도에실패할경우, 다음번양수검사일정이정해질것입니다. 가끔양수에서채취된세포가자라지않는이유로검사실에서태아의염색체를검사할수없습니다. 이러한경우는 0.5% 미만이며혹은 200 의 1 미만입니다.

3 태아기진단진료소양수검사 질문이있으십니까? 귀하의질문은중요합니다. 양수검사에관하여문의가있으시거나위험성, 이로운점또는대안의방도에관하여질문이있으시면동의서에서명하시기전에귀하의진료인과상담하십시오. 태아기진단진료소 : 산모및신생아간호진료서 : 양수검사의대안방도는무엇인가? 양수검사를받지않도록결정하실수있습니다. 양수검사를받는것은귀하의선택권이며이결정은개인적인결정입니다. 양수검사로진단될수있는건강문제는아기가태어난후에도진단될수있습니다. 일부여성들은건강문제의위험성이매우적다고느껴서염려할것이없다고생각합니다. 다른여성들은자연유산할위험성을원치않기때문에아기가태어한후에진단받기를선호합니다. 일부가족들은특수한건강필요성을가진아기의대하여진단을받지않아도출산을준비할수있다고느낍니다. 검사후어떠한잇따른간호가필요한가? 양수검사후좋지않은결과가없어야합니다. 귀하의작업이힘든육체적인활동을요구하지않는한직장에출근하실수있습니다. 양수검사후 24 시간에서 48 시간사이, 다음사항을권장합니다 : 가능한서서활동을하지마십시오. 여분의음료수를섭취하십시오. 다음활동을또한삼가하십시오 : 뛰거나다른운동같은심한육체적인활동을피하십시오. 무거운물건을들지마십시오 (10 파운드이상의물건 ). 성교또는성활동을하지마십시오. 양수검사후, 보통다음증세가일어납니다 : 검사후, 몇시간동안은생리통과같은가벼운복통이생깁니다 ( 이런경우타이레놀을복용하시면됩니다 ). 주사바늘이주입된피부부분에멍이들거나아프게됩니다. 의사에게전화할시각 양수검사후다음증세가나타날경우즉시귀하의진료인에게전화하십시오 : 질출혈이나피가비칠경우. 질에서맑은액체가흘러나올경우. 하복부에심한주기적인생리통및복통. 고열이나오한. 설사. 독감같은증세. Maternal and Infant Care Clinic Box N.E. Pacific St. Seattle, WA University of Washington Medical Center Korean 09/2003 Rev. 02/2009 Reprints: Health Online

5 Patient Education Prenatal Diagnosis Clinic Helping you understand your procedure and the consent form Please read this handout before reading and signing the form Special Consent for Procedural Treatment UH0173. This handout describes what to expect from an amniocentesis. Included are benefits, risks and complications, and alternatives. This handout is in addition to the talks you have with your health care providers. It is important that you fully understand this information, so please read these pages carefully. What is an amniocentesis? (am-nee-oh-sen-tee-sis) is a procedure that allows your baby to be tested for a variety of health problems. It is also called amnio. Amnio is done during the second trimester of pregnancy, usually between 16 and 22 weeks. How is an amniocentesis done? First, ultrasound is used to see your baby s position and to decide the safest way to do the procedure. The ultrasound stays on during the entire procedure, which takes about 2 minutes. While watching the baby by ultrasound, the doctor inserts a thin needle into your abdomen and removes about 2 tablespoons of amniotic fluid, the liquid that surrounds the developing baby. The needle does not touch the baby. You are welcome to have a partner, spouse, friend, or family member with you during your amnio. Most women are concerned about having an amnio. But, after it is done, nearly all women say that it was much simpler and quicker than they thought it would be. What medicines will be used? The doctor cleans the skin on your abdomen with an antiseptic soap before the amnio is done. If your blood type is Rh negative, you will be given a RhoGAM injection after the amnio to prevent problems in future pregnancies.

6 Page 2 Prenatal Diagnosis Clinic What can amnio test for? Amniotic fluid contains cells that have been shed from the baby s skin, which is a normal process. These cells can be used to diagnose some genetic conditions. The baby s chromosomes are examined, which will diagnose conditions such as Down syndrome and trisomy 18. If a hereditary condition such as cystic fibrosis or muscular dystrophy runs in the family, the baby s DNA can be tested to see if the baby has inherited the disorder. The amniotic fluid also has a protein in it called alpha fetoprotein (AFP). This protein is made by the baby. The amount of AFP in the amniotic fluid is a test for birth defects of the spine and brain, such as spina bifida. If there is concern that the baby has an infection, the fluid can be tested for some viruses. It may take up to 3 weeks to complete testing of the samples taken during your amnio. What are the benefits of an amniocentesis? 1. allows a clear diagnosis of some health problems. Some people find that knowing a diagnosis is better than being unsure about their baby s health. 2. Most of the time, test results are normal. If you have been worried about your baby s health, normal test results may make you feel better about your pregnancy. 3. Some women feel that having more information about the baby s health will help them prepare better for the baby s arrival. Others do not want to raise a child with special needs. Having a diagnosis allows parents to make choices, such as choosing an adoption plan or stopping the pregnancy. What are the risks and complications of an amniocentesis? The doctor will take steps to make the risks of the amnio as low as possible, but no procedure is completely risk-free. The major risk from amniocentesis is miscarriage. A miscarriage may occur if an infection starts in the amniotic fluid, or if the sac surrounding the baby doesn t heal after the procedure, allowing amniotic fluid to leak out. Without amniocentesis, about 1% to 2% (1 to 2 out of 100) of pregnancies will miscarry between 15 and 28 weeks. adds an extra 0.25% (1 out of 400) risk of miscarriage. Said another way, out of every 400 amniocentesis procedures done, 399 women (99.75%) do not have a miscarriage. There are some limitations to amniocentesis: Many health problems and birth defects are not diagnosed by amniocentesis or any other prenatal tests. Having normal test results from amniocentesis does not guarantee the baby is healthy (see information on the left side of this page). It is not always possible to obtain amniotic fluid. Sometimes the doctor can try a second time. If the second try doesn t work, your amnio will be rescheduled for another time. Sometimes the lab is not able to examine the baby s chromosomes because cells collected from the amniotic fluid do not grow. This happens less than 0.5% of the time, or less than 1 out of 200 times.

7 Prenatal Diagnosis Clinic Questions? Your questions are important. If you have any questions about amniocentesis or the risks, benefits, or alternatives to it, talk with your provider before signing any consent forms. Prenatal Diagnosis Clinic: Maternal and Infant Care Clinic: What are the alternatives to amniocentesis? You may decide not to have an amnio. Doing an amniocentesis is your choice, and the decision is a personal one. Health problems that can be diagnosed by amniocentesis can also be diagnosed when the baby is born. Some women feel the risk of a health problem is so low that they are not concerned. Others decide they don t want to risk a miscarriage and prefer to learn the diagnosis after the baby is born. Some families feel they can prepare for the birth of a child with special health needs without knowing a diagnosis. What follow-up care is needed? There should be no ill effects from the amniocentesis. You can return to work as long as your job does not require heavy physical activity. For 24 to 48 hours after your amnio, we suggest that you: Stay off your feet as much as possible. Drink extra fluid. Also avoid: Heavy physical activity, such as running or other exercise. Lifting heavy objects (10 pounds or more). Sexual intercourse or sexual activity. After an amniocentesis, it is normal to have: Mild, menstrual-like cramping for the first few hours (you can take Tylenol for this). Bruising or soreness on your skin where the needle was inserted. When to Call Your Doctor Call your health care provider right away if you have any of these symptoms after your amnio: Spotting or bleeding from your vagina. Leakage of clear fluid from the vagina. Severe or rhythmic cramping or pain in your lower abdomen. Fever or chills. Diarrhea. Flu-like symptoms. Maternal and Infant Care Clinic Box N.E. Pacific St. Seattle, WA University of Washington Medical Center 09/2003 Rev. 02/2009 Reprints: Health Online

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I&IRC5 TG_08권 I N T E R E S T I N G A N D I N F O R M A T I V E R E A D I N G C L U B The Greatest Physicist of Our Time Written by Denny Sargent Michael Wyatt I&I Reading Club 103 본문 해석 설명하기 위해 근래의 어떤 과학자보다도 더 많은 노력을