脐静脉穿刺用于产前诊断230例分析

Analysis of cordocentesis in 230 cases for prenatal diagnosis.

目的 探讨B超引导下游离脐带穿刺术成功率和安全性。方法 对 2 3 0例因各种原因行产前诊断的孕妇进行B超引导下游离脐静脉穿刺术。结果 10 2例 18～ 2 1周孕妇穿刺成功率为 90 5 % ,72例 2 2～ 2 8周孕妇成功率 97 8% ,5 6例 2 8周以上的成功率为 10 0 0 % ,总成功率 96 1% ;168例穿刺经过胎盘 ,胎盘渗血 2 9 2 %(49/ 168) ,脐带穿刺后渗血 17 8% (41/ 2 3 0 )。胎心过缓者占 5 2 % (12 / 2 3 0 )。术后未出现早产、宫内感染等并发症。

Objective To investigate the success rate and safety of puncturing the free umbilical cord under the guidance of ultrasound in prenatal diagnosis.Methods Free umbilical cords were punctured under ultrasound in 230 pregnant women for prenatal diagnosis.Results (1)The rate of success in cordocentesis was 90 5%,97 8% and 100% in 102 cases with gestational age ranging from 18 to 21 weeks,72 cases with gestational age ranging from 22 to 28 weeks and 56 cases with gestational age above 28 weeks,respectively.The total rate of success was 96 1% in 230 cases.(2)Complications:168 cordocentesis passed through placenta.The rate of the leakage of the blood from placentas and umbilical cords was 29 2%(49/168) and 17 8%(41/230) respectively.5 2%(12/230)produced bradycardia.Abortions,intrauterine fetal death,preterm delivery and chorioamnionitis had never happened after cordocentesis in 230 cases.Conclusion Puncturing free umbilical cord under ultrasonography is a safe and reliable method for prenatal diagnosis.