B超监测下经腹壁脐静脉穿刺采取胎儿血及其临床应用的研究

STUDY ON FETAL BLOOD SAMPLING BY USING DIRECT PUNCTURE OF THE UMBILICAL VEIN UNDER B-MODE ULTRASOUND GUIDANCE AND ITS CLINICAL USE

介绍在B超监测下经腹直接穿刺济静脉取胎儿血的研究结果及对其临床应用的评价,自1989年7月至1990年12月共采取胎儿血56例,其中晚期人工流产病人23例,产前咨询病人33例,建立了以抗碱变性试验法测定胎儿血HBF及应用测微器测红细胞直径法以区别胎儿血与母血。脐静脉穿刺采取胎儿血成功率为98.21％,对12例母儿血型不合病例明确了诊断并进行治疗,预后良好,对有异常孕产史的孕妇检查出先天性巨细胞病毒感染8例,先天性弓形体感染1例,对3例有进行性肌营养不良病史的孕妇通过产前诊断确定了处理原则,对10例胎儿畸形的病例进行了产前诊断并终止妊娠。所有进行脐带穿刺的病倒无一发生母婴并发症。

This paper presented the results of the study on fetal blood sampling by using percutaneously direct puncture of umbilical vein under B--mode ultrasound guidance and the evaluation of its clinical application. From July 1989 to December 1990, 56 cases fetal blood samples including 23 cases of late artificial abortions and 33 cases of prenatal counseling were taken. Antibesic degeneration test was established for determing the HbF, and the fetal blood was distinguished from maternal blood by measuring the diameter of red blood cell with micrometer. The successful rate of fetal blood sampling was 98.21%. 12 patients with maternal--fetal blood group incompatibility were diagnosed confirmedly and treated with good results. Among those pregnant women with abnormal obstetric history, congenital CMV--infection was detected in 8 cases and congenital toxoplasma gondil infection in 1 case. The therapeutic principles were made in 3 cases with history of progressive myodystrophy confirmed by prenatal diangnosis Prenatal diagnoses of 10 cases with fetal malformation were made and termination of pregnancies were performed. None of all these cases with cordocentesis had any maternal--fetal complications. Based on the clinical observation, the authors propose that through a definite training, this technique will be considerable simple and safe with high guccessful rate of fetal blood sampling which may play a great role in prenatal diagnosis and even in fetal therapy.