Eddleman K A, Stone J L, Lynch L, Berkowitz R L
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Medical Center, New York, New York, USA.
Am J Obstet Gynecol. 2000 Nov;183(5):1078-81. doi: 10.1067/mob.2000.108868.
This study was undertaken to determine the technical feasibility and accuracy of chorionic villus sampling before multifetal pregnancy reduction and to determine whether sampling increases the pregnancy loss rate after the reduction procedure.
Between January 22, 1986, and January 20, 2000, a total of 1183 patients underwent first-trimester multifetal pregnancy reduction at Mount Sinai Medical Center. Chorionic villus sampling was attempted in 86 patients before the reduction procedure. Information on the technical success and accuracy of chorionic villus sampling, as well as pregnancy outcome, was collected on all patients. Pregnancy loss rates before 24 weeks' gestation in patients undergoing chorionic villus sampling before multifetal pregnancy reduction were compared with rates in patients not undergoing sampling.
Chorionic villus sampling was successfully completed in 85 (98.8%) of 86 patients in whom sampling was attempted. Of 166 fetuses, 165 (99.4%) were successfully sampled. Of 165 fetuses, 3 (1.8%) had karyotypic abnormalities. Sampling errors were probably made in 2 (1.2%) of 165 fetuses. Of the 73 patients who have been delivered or are beyond 24 weeks' gestation, only 1 patient (1.4%) had a pregnancy loss after the multifetal pregnancy reduction.
Chorionic villus sampling before multifetal pregnancy reduction is technically feasible and accurate, with an acceptably low sampling error rate. Chorionic villus sampling before multifetal pregnancy reduction appears to be safe and does not increase the risk of loss after the reduction procedure.
本研究旨在确定多胎妊娠减胎术前绒毛取样的技术可行性和准确性，并确定取样是否会增加减胎术后的妊娠丢失率。
在1986年1月22日至2000年1月20日期间，共有1183例患者在西奈山医疗中心接受了孕早期多胎妊娠减胎术。其中86例患者在减胎术前尝试进行了绒毛取样。收集了所有患者关于绒毛取样的技术成功情况、准确性以及妊娠结局的信息。将多胎妊娠减胎术前接受绒毛取样的患者在妊娠24周前的妊娠丢失率与未接受取样的患者的妊娠丢失率进行了比较。
在尝试取样的86例患者中，85例（98.8%）成功完成了绒毛取样。166例胎儿中，165例（99.4%）成功取样。165例成功取样的胎儿中，3例（1.8%）存在染色体核型异常。165例胎儿中可能有2例（1.2%）出现取样错误。在已分娩或孕周超过24周的73例患者中，只有1例（1.4%）在多胎妊娠减胎术后发生了妊娠丢失。
多胎妊娠减胎术前绒毛取样在技术上是可行且准确的，取样错误率可接受地低。多胎妊娠减胎术前绒毛取样似乎是安全的，且不会增加减胎术后的丢失风险。
