DEV ARYAN

Definition

Amniocentesis is a test during pregnancy that removes a small amount of fluid from the sac around the baby to look for birth defects and chromosome problems.

Alternative Names

Culture - amniotic fluid; Culture - amniotic cells

How the test is performed

Amniocentesis is done on an outpatient basis. You do not need to stay in the hospital.

The doctor will find the exact location of the baby, usually by performing a pregnancy ultrasound.

The health care provider will clean an area of skin on the mother's belly area. A numbing medication (anesthetic) may be applied to the skin, or a local anesthetic may be injected into the skin.

The doctor inserts a long, thin needle through the abdomen and into the womb (uterus). A small amount of fluid is taken from the fluid-filled sac that surrounds the baby.

How to prepare for the test

Your bladder must be full for the ultrasound. There are no food or drink restrictions.

You may need to provide a blood sample to determine your blood type and Rh factor. You may get an injection of a medication called Rhogam if you are Rh negative.

You will need to sign a consent form before the test.

How the test will feel

If an anesthetic is used, you may feel a sharp, stinging sensation for a few seconds. When the needle enters the amniotic sac, you may feel a sharp pain lasting a few seconds.

Some women feel pressure in the lower abdomen when the fluid is pulled out. After the procedure, you may have some minor cramping.

Why the test is performed

The test can find chromosome problems such as:

• Anencephaly
• Down syndrome
• Rare, inherited metabolic disorders
• Spina bifida and other structure problems

Later on in a pregnancy, the test may be used to find problems such as:

• Infection
• Rh incompatibility

This test is also sometimes done later in pregnancy to determine whether the baby's lungs are developed if there is a condition that requires early delivery.

Definition

Addiction is a physical or mental dependence on a behavior or substance that a person feels powerless to stop.

Description

Addiction is one of the most costly public health problems in the United States. It is a progressive syndrome, which means that it increases in severity over time unless it is treated. The term has been partially replaced by the word "dependence" for substance abuse. Addiction has been extended, however, to includemood-altering behaviors or activities. Some researchers speak of two types of addictions: substance addictions (for example, alcoholism, drug abuse, andsmoking); and process addictions (for example, gambling, spending, shopping, eating, and sexual activity). There was as of 2004 a growing recognition that many addicts are addicted to more than one substance or process. Substance abuse is characterized by frequent relapse or return to the abused substance. Substance abusers often make repeated attempts to quit before they are successful.

The National Survey on Drug Use and Health (NSDUH) is conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S.Department of Health and Human Services. Among the findings of the 2003 study are the following:

• In 2003, an estimated 19.5 million Americans, or 8.2 percent of the population aged 12 or older, were current illicit drug users. Current illicit drug use means use of an illicit drug during the month prior to the survey interview. The numbers did not change from 2002.
• The rate of illicit drug use among youths aged 12–17 did not change significantly between 2002 (11.6%) and 2003 (11.2%), and there were no changes for any specific drug. The rate of current marijuana use among youths was 8.2 percent in 2002 and 7.9 percent in 2003. There was a significant decline in lifetime marijuana use among youths, from 20.6 percent in 2002 to 19.6 percent in 2003. There also were decreases in rates of past year use of LSD (1.3 to 0.6%), ecstasy (2.2 to 1.3%), andmethamphetamine (0.9 to 0.7%).
• About 10.9 million persons aged 12–20 reported drinking alcohol in the month prior to the survey interview in 2003 (29.0 percent of this age group). Nearly 7.2 million (19.2%) were binge drinkers and 2.3 million (6.1%) were heavy drinkers. The 2003 rates were essentially the same as those from the 2002 survey.
• An estimated 70.8 million Americans reported current (past month) use of atobacco product in 2003. This is 29.8 percent of the population aged 12 or older, similar to the rate in 2002 (30.4%). Young adults aged 18–25 reported the highest rate of past month cigarette use (40.2%), similar to the rate among young adults in 2002. An estimated 35.7 million Americans aged 12 or older in 2003 were classified as nicotine dependent in the past month because of their cigarette use (15% of the total population), about the same as for 2002.

Causes and symptoms

Addiction to substances results from the interaction of several factors.

Drug chemistry

Some substances are more addictive than others, either because they produce a rapid and intense change in mood or because they produce painful withdrawal symptoms when stopped suddenly.

Genetics

Some people appear to be more vulnerable to addiction because their body chemistry increases their sensitivity to drugs. Some forms of substance abuse and dependence seem to run in families; a correlation that may be the result of a genetic predisposition, environmental influences, or a combination of the two.

Brain structure and function

Using drugs repeatedly over time changes brain structure and function in fundamental and long-lasting ways. Addiction comes about through an array of changes in the brain and the strengthening of new memory connections. Evidence suggests that those long-lasting brain changes are responsible for the distortions of cognitive and emotional functioning that characterize addicts, particularly thecompulsion to use drugs. Although the causes of addiction remain the subject of ongoing debate and research, many experts as of 2004 considered addiction to be abrain disease, a condition caused by persistent changes in brain structure and function. However, having this brain disease does not absolve the addict of responsibility for his or her behavior, but it does explain why many addicts cannot stop using drugs by sheer force of will alone.

Social learning

Social learning is considered the most important single factor in causing addiction. It includes patterns of use in the addict's family or subculture, peer pressure, and advertising or media influence.

Availability

Inexpensive or readily available tobacco, alcohol, or drugs produce marked increases in rates of addiction. Increases in state taxes on alcohol and tobacco products have not resulted in decreased use.

Personality

Before the 1980s, the so-called addictive personality was used to explain the development of addiction. The addictive personality was described as escapist, impulsive, dependent, devious, manipulative, and self-centered. Many doctors in the early 2000s believe that these character traits develop in addicts as a result of the addiction, rather than the traits being a cause of the addiction.