Bartosch B, Klein M, Beck A, Schnedl W
Geburtshilflich-gynäkologische Abteilung, Hanusch-Krankenhaus, Wien.
Geburtshilfe Frauenheilkd. 1991 Nov;51(11):886-9. doi: 10.1055/s-2008-1026230.
Prenatal diagnosis of chromosomal and biochemical defects is accepted as a routine in high-risk patients. To eliminate the disadvantages of traditional amniocentesis (late diagnosis) and of chorion villus sampling (placentar mosaics, higher fetal loss rate) we evaluated the facts on amniocentesis during the first 12 weeks of pregnancy. 42 samples were analysed. 21 amniotic fluid samples were from pregnancies before the 13th week of gestation, 21 further punctures were performed between the 13th to 15th week and served as comparative figures. Of 21 samples, diagnosis was possible in 16 cases. Four cultures did not show any growth of cells; in one case, amniotic fluid could not be aspirated. In the comparison group chromosomal diagnosis could be done in every case. An average of 12.3 ml of amniotic fluid were taken. Chromosomal disorders found, included a translocation in chromosome 13/14 as well as a trisomy of chromosome 18. Biochemical defects such as Gaucher's disease and Niemann-Pick disease were excluded. 30 pregnancies without pathological symptoms were seen (mean birth weight 3200 g, mean duration of pregnancy 39 weeks). One case of abortion following amniocentesis was found in the 16th week of gestation. One case of premature delivery occurred in the 34th week and the pregnancy of a 40-year old women was complicated by EPH gestosis while 9 pregnancies were terminated by interruption following the patients' wish. Because chromosomal diagnosis could not be performed in five of 21 cases, amniocentesis during the 13th week of gestation cannot be recommended as a routine method. Early amniocentesis, however, is an alternative to the traditional amniocentesis at the 16th week of gestation.
对高危患者进行染色体和生化缺陷的产前诊断已成为常规操作。为了消除传统羊膜穿刺术(诊断较晚)和绒毛取样术(胎盘嵌合体、胎儿丢失率较高)的弊端,我们评估了妊娠前12周进行羊膜穿刺术的相关情况。共分析了42份样本。21份羊水样本来自妊娠13周前,另外21次穿刺在妊娠第13至15周进行,作为对照数据。在21份样本中,16例可以做出诊断。4份培养物未显示细胞生长;1例未能抽出羊水。在对照组中,每例均可进行染色体诊断。平均抽取羊水12.3毫升。发现的染色体疾病包括13/14号染色体易位以及18号染色体三体。排除了诸如戈谢病和尼曼-匹克病等生化缺陷。观察到30例无病理症状的妊娠(平均出生体重3200克,平均妊娠时长39周)。在妊娠第16周发现1例羊膜穿刺术后流产。1例在第34周早产,1名40岁女性的妊娠并发妊娠高血压综合征,9例妊娠应患者要求终止妊娠。由于21例中有5例无法进行染色体诊断,妊娠第13周的羊膜穿刺术不能作为常规方法推荐。然而,早期羊膜穿刺术可作为妊娠第16周传统羊膜穿刺术的替代方法。