经皮脐静脉穿刺术在产前诊断中的应用

Application of Percutaneous Cordocentesis in Prenatal Diagnosis

目的探讨经皮脐静脉穿刺术在产前诊断中应用的指征及安全性。方法对≥24孕周、因各种原因进行产前诊断的136例孕妇行B超引导下的经皮脐静脉穿刺术。结果穿刺成功率100%,流产发生率0.7%,胎心减慢发生率5.9%,无胎死宫内发生。共检出母儿血型不合1例,宫内感染2例,染色体异常3例。结论B超引导下经皮脐静脉穿刺术是较安全且适应证较宽泛的介入性产前诊断技术,可用于胎儿遗传学分析及胎儿宫内感染、溶血的诊断。

Objective To explore the index and safety of cordocentesis used in the prenatal diagnosis.Methods Free umbilical cord was punctured under ultrasound in 136 pregnant women for prenatal diagnosis.Results The total success rate of cordocentesis was 100%,the abortion rate correlated with cordocentesis was 0.7%（1/136）,no fetal death happened,the rate of the leakage of the blood from placenta and umbilical cord was 16.9%（23 /136）and 11.8%（16/136）.Two fetuses with intrauterine infection and 1 fetus with maternal fetal blood group incompatibility and 3 fetuses with chromosome disorders were prenatal diagnosed. Conclusion The cordocentesis under ultrasonogra- phy is safe and widely used in prenatal diagnosis fetal cytogenetic analysis,moleculer genetic analysis, fetal infection and hemolyzation in uterus.