Würfel W, Haas-Andela H, Krüsmann G, Rothenaicher M, Hirsch P, Kwapisz H K, Haas J, Högemann I, Fiedler K
Frauenklinik Dr. Krüsmann, Munich, FRG.
Eur J Obstet Gynecol Reprod Biol. 1992 Mar 23;44(1):47-52. doi: 10.1016/0028-2243(92)90312-m.
We report on the outcome of 82 amniocenteses (AC) carried out during pregnancies after in vitro fertilization (IVF) from 1-1-1985 to 31-12-1989. The main indication for amniocentesis was a maternal age of greater than or equal to 35 years. In 48 cases, we found an anterior placenta and assumed that this was related to the position in which the uterine embryo transfer was performed. In six pregnancies, we found an abnormal karyotype, including two cases of trisomy 21; the two couples decided for abortion. Four aberrations in the fetal karyotypes were also present in either the mother or the father, the resulting children are healthy. The further course of pregnancies after IVF and AC was characterized by a higher incidence of toxemia, uterine bleeding before the 28th week of gestation, abruptio placentae, and premature deliveries, when compared to the course of pregnancies after spontaneous conception. We believe that these occurrences were not caused by AC, as the incidence was higher in all our pregnancies after IVF (without AC) and has also been reported in pregnancies after ovarian hyperstimulation without IVF. Therefore, we see no reason to renounce AC after IVF. However, the special risks inherent in pregnancies after IVF must always be discussed with the couple.
我们报告了1985年1月1日至1989年12月31日期间在体外受精（IVF）后的妊娠中进行的82次羊膜穿刺术（AC）的结果。羊膜穿刺术的主要指征是孕妇年龄大于或等于35岁。在48例中，我们发现胎盘前置，并推测这与子宫内胚胎移植的位置有关。在6例妊娠中，我们发现了异常核型，其中包括2例21三体综合征；这两对夫妇决定终止妊娠。胎儿核型中的4种畸变也出现在母亲或父亲一方，其后代健康。与自然受孕后的妊娠过程相比，IVF和AC后的妊娠进一步发展的特点是毒血症、妊娠28周前子宫出血、胎盘早剥和早产的发生率较高。我们认为这些情况不是由AC引起的，因为在我们所有IVF后的妊娠（未进行AC）中发生率都较高，并且在未进行IVF的卵巢过度刺激后的妊娠中也有报道。因此，我们认为没有理由放弃IVF后的AC。然而，必须始终与夫妇讨论IVF后妊娠所固有的特殊风险。
