经母腹抽取胎儿脐静脉血行产前诊断110例

PERCUTANEOUS UMBILICAL BLOOD SAMPLING GUIDED BY ULTRASONOGRAPHY IN PRENATAL DIAGNOSIS OF 110 CASES

自1990年3月至1991年4月在B超监护下,经母腹抽取胎儿脐静脉血110例,对染色体病、脆性X综合征、风疹、巨细胞病毒、弓形体原虫感染、地中海贫血(地贫)、血友病等进行了产前诊断。发现巴氏水肿胎9人、胎儿风疹感染4人,男胎甲型重型血友病2人(已引产)、甲型轻型地贫17人,染色体平衡易位4人,共36人,占受检人数的32.7%。其中1次穿刺成功103人(93.6%),2次穿刺成功6人(5.4%),8次穿刺成功1人(0.9%)。手术时间86%在15分钟内完成。主要并发症有:脐带出血33人(30%),胎盘出血38人(34.5%),胎儿心动过缓12人(10.9%)。胎儿死亡2人(1.8%)。

Percutaneous umbilical blood sampling (PUBS) guided by ultrasonography was performed from March 1990 to April 1991 in 110 pregnant women for prenatal diagnosis of chromosomal diseases fragile X syndrome, α-thalassemia, hemophilia, and congenital infection (rubella, toxoplasmosis, and cytomegalovirus). Of the 110 cases, 35 cases (35.5%) were found to have some problems, which include 9 Bart's hydrops, 4 rubella infections, 2 male hemophilia A (All of them were given induced abortion), 17 moderately α-thalassemia and 4 chromosome translocations. For sampling of blood from the 110 fetuses, 93.6% of the procedures (103 samples) were successful on the firs, try; 5.4%(6 samples) succeeded on the second try and 0.9% (1 sample) succeeded by three attempts. Eighty-six percent of the procedures were completed within 15 minutes. The main complications were: blood leakage from the puncture site in 33 procedures(30%), placenta bleeding in 38 procedures(34.5%), fetal bradycardia in 12 procedures(10%), and fetal death in 2 procedures(1.8%).