Some people seem to think that amnios are experimental or dangerous and that ultrasound exams are unnecessary, inaccurate, and the same everywhere. Amnios and ultrasound have both been improved enormously during the many years that each has been available.
Amniocentesis was used first in Germany to drain excess amniotic fluid from the uterus in the 1890's. From the 1930's to the 1960's Radiographic contrast materials were injected through the amniocentesis needle in order to make highly detailed X-ray images of fetuses, which was helpful in diagnosing some serious problems like meningomyeloceles (protrusions of neural tissue and membranes through a spinal defect) and interruptions in the esophagus. The modern, diagnostic stage of amniocentesis began in the 1950's as a way of identifying fetal anemia and indicating transfusion in Rh disease - hemoglobin break down products change the optical properties of fluid which can be measured precisely. Karyotyping (i.e. checking chromosomes in fetal skin cells floating in amniotic fluid) was reported soon afterwards and became a potentially routine prenatal procedure when we reported our method for using ultrasound for safe guidance of needle placement in 1978.
Echo testing, i.e. medical ultrasound, SONAR and RADAR are technical descendants of the ancient tradition of rapping on a keg of fermenting wine and judging the amount of gas within from the sound that is produced. This was introduced in medicine as the physical examination technique known as "percussion" in Austria in the 18th century. SONAR was proposed in 1911 by an English inventor EG Richardson. Medical imaging utilzing sound pulses reflected from structures within the body is attributed to DH Howry and WR Bliss in Denver in 1947; the clinical use of ultrasound for diagnosis in Obstetrics and Gynecology stems from the pioneering work of Ian Donald in Glasgow in the mid to late 1950. Equipment from the 1960's only showed the outlines of large, bony structures, like the head and spine, which may not seem like much in comparison with what we do now, but it was a revolutionary advance for Obstetrical care.
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The left image shows a V-shaped sonic flare that marks the tip of a very thin needle during amniocentesis. The needle is positioned free in fluid, well away from the fetus. Ultrasound video is continuous during needle placement. This image is typical of the 1970's and 1980's. The right image is Matt, when he was a college student. His amnio was at the Boston Hospital for Women (now the Brigham and Women's Hospital) in 1978. He is now a Doctor.
