You see a 42-year-old patient in your office who is now 5 weeks pregnant with her fifth baby. She is very concerned regarding the risk of Down syndrome because of her advanced maternal age. After extensive genetic counseling, she has decided to undergo a second-trimester amniocentesis to determine the karyotype of her fetus. Prior to performing the procedure, you inform the patient that all of the following are possible complications of the amniocentesis except

Amniocentesis performed in the second trimester has been associated with a 1 to 2% risk of amniotic fluid leakage, a fetal loss rate of less than 0.5%, transient transvaginal spotting, a less than 0.1% risk of chorioamnionitis, and a rare risk of cell culture failure. There has not been an association of amniocentesis in the second trimester with fetal limb reduction defects. Chorionic villus sampling performed at a gestational age of less than 9 weeks has been associated with fetal limb reduction defects.