Tóth-Pál Erno, Papp Csaba, Beke Artúr, Bán Zoltán, Papp Zoltán
1st Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
Fetal Diagn Ther. 2004 Mar-Apr;19(2):138-44. doi: 10.1159/000075138.
Second-trimester genetic amniocentesis is the most frequently used invasive prenatal diagnostic technique. Several reports have been published about the effect of genetic amniocentesis on fetal loss in multiple pregnancies over the past two decades. Here we analyze our experience with genetic amniocentesis in multiple pregnancies over the past 10 years.
Details of 184 multiple pregnancies were processed in all cases in whom genetic amniocentesis was performed in women who presented at our department since 1990. The outcomes of 175 cases (95.1%) out of 184 genetic amniocenteses were available to us. As a control group, we followed up the outcome of 300 twin pregnancies in which no genetic amniocenteses were performed.
We found that the proportion of spontaneous losses in multiple pregnancies between the 18th and the 24th gestational weeks was 2.39%, whereas if genetic amniocentesis was performed the loss rate before the 24th week was 3.87%. The perinatal mortality rate was 10.03/1,000 in the group who underwent amniocentesis, while it was 10.52/1,000 in the group without amniocentesis.
Our results suggest that the genetic amniocentesis performed in multiple pregnancies slightly increased (1.48%) the fetal loss rate until the 24th week. Beyond 5 weeks after the procedure, no consequent fetal loss should be expected. In our study the intervention did not have any undesired effect on perinatal mortality rates.
孕中期遗传羊膜腔穿刺术是最常用的侵入性产前诊断技术。在过去二十年里,已有多篇关于遗传羊膜腔穿刺术对多胎妊娠胎儿丢失影响的报道。在此,我们分析过去十年间我们在多胎妊娠中进行遗传羊膜腔穿刺术的经验。
对自1990年以来在我院接受遗传羊膜腔穿刺术的所有女性的184例多胎妊娠详细情况进行了处理。我们获得了184例遗传羊膜腔穿刺术中175例(95.1%)的结果。作为对照组,我们随访了300例未进行遗传羊膜腔穿刺术的双胎妊娠结局。
我们发现,妊娠第18至24周期间多胎妊娠的自然丢失率为2.39%,而进行遗传羊膜腔穿刺术的情况下,第24周前的丢失率为3.87%。接受羊膜腔穿刺术组的围产儿死亡率为10.03/1000,而未进行羊膜腔穿刺术组为10.52/1000。
我们的结果表明,多胎妊娠中进行遗传羊膜腔穿刺术会使第24周前的胎儿丢失率略有增加(1.48%)。术后5周以后,不应预期会有后续胎儿丢失。在我们的研究中,该干预措施对围产儿死亡率没有任何不良影响。