Makrydimas G, Kaponis A, Skentou C, Lolis D
Department of Obstetrics and Gynaecology, Ioannina University Hospital, Ioannina, Greece.
Ultrasound Obstet Gynecol. 2002 Mar;19(3):243-5. doi: 10.1046/j.1469-0705.2002.00646.x.
Celocentesis offers the potential for prenatal diagnosis from as early as 6 weeks of gestation. The aim of this study was to examine the short-term safety of celocentesis.
Eligible for the study were pregnant women with single live fetuses at 6-10 weeks of gestation, requesting pregnancy termination for social indications. At presentation, the patients were asked if they were willing to undergo celocentesis and in those women who agreed the procedure was performed at the time of the initial scan. A second scan was carried out just before termination to measure fetal crown-rump length and heart rate.
Four hundred and forty-seven women requested termination of pregnancy and 108 of these agreed to have celocentesis. There were no significant differences between the groups in maternal age, prevalence of primigravidas, cigarette smokers, existence of uterine fibroids, the median fetal crown-rump length or the interval between the initial scan (or celocentesis) at presentation and the pregnancy termination. At the time of termination, ultrasound examination demonstrated fetal death in five (4.7%) of the celocentesis group and nine (2.7%) of the controls (odds ratio, 1.804; 95% confidence interval, 0.5912-5.504). In all other cases, there was normal fetal growth and there were no significant differences between the groups in fetal crown-rump length.
The procedure related fetal loss associated with celocentesis may be approximately 2%.
早在妊娠6周时,羊膜腔穿刺术就为产前诊断提供了可能。本研究的目的是检验羊膜腔穿刺术的短期安全性。
本研究的入选对象为妊娠6 - 10周、单活胎、因社会因素要求终止妊娠的孕妇。就诊时,询问患者是否愿意接受羊膜腔穿刺术,对于同意的女性,在初次超声检查时进行该操作。在终止妊娠前进行第二次超声检查,测量胎儿顶臀长度和心率。
447名女性要求终止妊娠,其中108名同意接受羊膜腔穿刺术。两组在产妇年龄、初产妇比例、吸烟者、子宫肌瘤的存在情况、胎儿顶臀长度中位数或就诊时初次超声检查(或羊膜腔穿刺术)与终止妊娠之间的间隔方面无显著差异。在终止妊娠时,超声检查显示羊膜腔穿刺术组有5例(4.7%)胎儿死亡,对照组有9例(2.7%)胎儿死亡(优势比,1.804;95%置信区间,0.5912 - 5.504)。在所有其他情况下,胎儿生长正常,两组在胎儿顶臀长度方面无显著差异。
与羊膜腔穿刺术相关的手术导致的胎儿丢失率可能约为2%。