羊膜腔穿刺与脐静脉穿刺比较研究

Comparative study between amniocentesis and cordocentesis

目的分析羊膜腔穿刺与脐静脉穿刺的准确性及其所致的并发症,以寻找一种最佳的产前诊断标本采集方法。方法对有产前诊断指征的203名妊娠17～37周的孕妇行羊膜腔穿刺或脐静脉穿刺术,取羊水细胞或脐血淋巴细胞培养、分析胎儿染色体核型及两种穿刺所引起的并发症。结果除脐静脉穿刺中的2例(占0.98%)发生母血污染外,经羊膜腔穿刺和脐静脉穿刺所获的201例标本全部培养成功,培养成功率为99.02%(201/203),203例中,97例(孕20～37周)为脐静脉穿刺,脐静脉穿刺致胎儿丢失3例,占3.09%(3/97);胎儿一过性心动过缓5例,占5.15%(5/97)。106例(孕17～22周)为羊膜腔穿刺,未发生任何并发症。结论羊膜腔穿刺引起的并发症少、技术难度小,在孕中期(17～22周)行羊膜腔穿刺是宫内产前诊断标本采集的最安全方法。

[Objective] To analyze the accuracy and complications of amniocentesis and cordocentesis and look for the best method that collect specimen used for prenatal diagnosis. [Methods] Cordocentesis or amniocentesis were performed in 203 pregnant women with the indications of prenatal diagnosis during 17-37 gestational weeks and the complications were analysed. [Results] In addition to the presence of maternal contamination of the sample in 2 cases （0.98%） that performed Cordocentesis, The other 201 specimens were successful to culture. Cordocentesis were performed in 97 pregnant women with the indications of prenatal diagnosis during 20-37 gestational weeks. Among these cases, transient fetal bradycardia was observed in 5 cases （5.15%）. The procedure-related fetal loss rate was 3.09% （3 cases of abortions）. No complication was observed in 106 pregnant women with the indications of prenatal diagnosis during 17-22 gestational weeks that performed amniocentesis. [Conclusions] The complication of amniocentesis is few than that of cordocentesis. Amniocentesis during 17-22 gestational weeks is the safest method of collecting specimen used for prenatal diagnosis.