Amniocentesis: Pandora's box.

Amniocentesis is a medical marvel. It allows us to gain information about the genetic formation of the fetus and, if mongoloid, allows the parents the option of aborting the fetus. Mongolism is a terrible illness, involving severe retardation and often distortion of one or more vital organs, and the human costs in guilt, conflict, and tension to most families who have mongoloid children are hard to overstate. Moreover, the public cost for the care of mongoloids runs into more than $1.7 billion a year. Is amniocentesis not unlike the Salk vaccine, to be used first to halve, eventually to eradicate mongolism from our society via mass testing and abortion? We love quick fixes, and this one seems to fit the bill. However, it does also open a Pandora's box of problems which we must face-not to stop amniocentesis, but to help us use it wisely. Health risks-the test While the procedure has been more completely evaluated than many others by a nationwide, carefully designed study, and found surprisingly safe, all interventions-especially once used on a mass basis, not just by those highly trained-involve a risk. Nor has the effect of amniocentesis on the fetus (as distinct from its effect on the pregnant woman) been studied. J~rring the fetus' environment, changing the amount of fluid in which it floats and, above all, the use of sonar beams (to place the fetus so it will not be hit by the needle used in the test) may harm the fetus. It would not be the first time a procedure first reported safe was later found to be less wisely and widely indicated. Meanwhile, one must ask: what probability of mongolism (which rises sharply with the age of the