Tongprasert Fuanglada, Tongsong Theera, Wanapirak Chanane, Sirichotiyakul Supatra, Piyamongkol Wirawit
Faculty of Medicine, Chiang Mai University, Obstetrics and Gynecology, Thailand.
Prenat Diagn. 2007 Dec;27(12):1100-3. doi: 10.1002/pd.1836.
To describe the experiences in diagnostic cordocentesis in twin pregnancies at midpregnancy
The database and medical records of pregnant women attending Maternal Fetal Medicine Unit of the hospital for diagnostic cordocentesis at midpregnancy between January 1989 and September 2006 were retrospectively reviewed.
During 17 years of experience, 4,241 cordocenteses at midpregnancy were performed for prenatal diagnosis, including 59 procedures in 30 multiple pregnancies (29 twins and 1 triplet). The mean gestational age at the time of cordocentesis was 19.5 +/- 1.6 weeks. Success rate of the samplings was 98.3% with one sample was maternal blood contamination. Averaged-time used of the procedures was 8.2 minutes (range 1-45 minutes). The procedure-related complications included transient bleeding at puncture site (8.5%) and transient fetal bradycardia (22.0%). The total fetal loss rate was 10.5% but there was no cordocentesis-related fetal loss (0.0%), defined as a fetal loss within 2 weeks after the procedure.
This study may provide a new insight on the safety of cordocentesis in multifetal pregnancies at midpregnancy. The procedure-related fetal loss is not as high as reported in the past. This study suggests cordocentesis be a relatively safe and highly successful in obtaining fetal blood samples.
描述孕中期双胎妊娠诊断性脐血穿刺的经验。
回顾性分析1989年1月至2006年9月期间在本院母胎医学科进行孕中期诊断性脐血穿刺的孕妇的数据库和病历。
在17年的经验中,共进行了4241次孕中期脐血穿刺用于产前诊断,其中30例多胎妊娠(29例双胎和1例三胎)进行了59次操作。脐血穿刺时的平均孕周为19.5±1.6周。采样成功率为98.3%,有1例样本被母血污染。操作平均用时8.2分钟(范围1 - 45分钟)。与操作相关的并发症包括穿刺部位短暂出血(8.5%)和短暂性胎儿心动过缓(22.0%)。总胎儿丢失率为10.5%,但无脐血穿刺相关的胎儿丢失(0.0%),即操作后2周内的胎儿丢失。
本研究可能为孕中期多胎妊娠脐血穿刺的安全性提供新的见解。与操作相关的胎儿丢失并不像过去报道的那么高。本研究表明脐血穿刺在获取胎儿血样方面相对安全且成功率高。