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Date of Award

5-2020

Document Type

Thesis - Campus Access Only

Abstract

Objective Celocentesis, a method of prenatal diagnosis, accesses coelomic fluid, which is comprised of maternal cells and proteins produced by the embryonic cells surrounding the amniotic sac and available as early as 5 weeks of gestation via needle aspiration. The technique can potentially provide unique clinical value for religious sects with restrictive, sometimes time- sensitive termination laws, such as Orthodox Judaism where the statement from the Talmud: “a fetus less than 40 days from conception is considered mere water” is seen by many scholars as permitting termination prior to 40 days from conception.

Methods A meta-analysis was conducted of all relevant celocentesis studies published prior to January 1, 2020 to assess loss rates, collection of samples, accuracy of results, maternal cell contamination (MCC), return of results, and potential limb deformities. Results Loss rates significantly decreased over time, from 25% in 1997 to 2.8% in 2018. Sample collection was successful in 100% of evaluated studies and accuracy of results were confirmed in >96% of samples using Chorionic Villi Sampling, Amniocentesis, Products of Conception or Live Birth testing, with a 100% concordance rate in confirmed samples. Samples displayed a wide range of MCC yet allowed return of results in >96% of cases. To date, there have been no reports of limb deformities in the literature.

Conclusion Celocentesis offers a method of early prenatal diagnosis that may provide clinical value for a population where there are religious and cultural obstacles to the use of existing prenatal testing.

Submission Agreement

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