Developing a training simulator for amniocentesis

Dr Annette Briley, Mr Paul Seed, Dr Graham Tydeman, Professor Andrew Shennan

Tommy’s is helping to create a model that lets medical staff practice this diagnostic test to make it safer for mother and baby.

Amniocentesis is a test that can be carried out in early pregnancy to check if a baby has any genetic problems. It is usually offered around 15-20 weeks into pregnancy. A needle is used to take a sample of amniotic fluid, which surrounds the baby in the womb. This fluid contains cells from the baby that can then be tested in a laboratory for genetic conditions. The test is usually guided by ultrasound: a scan that uses high frequency waves to create a picture of the inside of the body.

Amniocentesis is not usually offered to all expecting mothers as it involves a small risk of miscarriage – around 1%. For this reason, it is only offered to women who are at high risk – for example, if an earlier test has suggested that there may be a problem,  

It is essential that the person doing the test is trained in both using ultrasound and guiding the needle so that it doesn’t harm the baby or the placenta. This is even more important in obese women, where it can be difficult to place the needle.

Because of the risks, the Royal College of Obstetricians and Gynaecologists recommends that anyone who carries out amniocentesis should be trained on a simulator first. However at the moment, there aren’t any devices that let health carers practice in a way that really helps to prepare them.

Tommy’s has teamed up with Guy’s and St. Thomas’ Charity to create a simulator that will let doctors practice amniocentesis in women of different weights. We already have a final model, which will be produced by the company Adam Rouilly. The model uses materials that are strong enough for using many times, but similar enough to the human body to give realistic ultrasound scans. We will now test the simulator and make any changes needed to improve it.

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This study takes place in a Tommy's centre and is funded by Tommy's and Guy's and St Thomas' Charity

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