绒毛取样相关疼痛：经腹与经宫颈途径

Pain associated with chorionic villus sampling: transabdominal vs transcervical approach.

作者信息

Wax Joseph R, Davies Norman P, Watson William J, Cartin Angelina, Pinette Michael G, Chard Renée, Carpenter Molly

机构信息

Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME, USA.

出版信息

Am J Obstet Gynecol. 2009 Oct;201(4):400.e1-3. doi: 10.1016/j.ajog.2009.06.064. Epub 2009 Aug 15.

DOI:10.1016/j.ajog.2009.06.064

PMID:19683693

Abstract

OBJECTIVE

The purpose of this study was to compare anticipated and perceived pain that is associated with transabdominal and transcervical chorionic villus sampling (CVS).

STUDY DESIGN

Women with singleton pregnancies who were undergoing CVS completed a preprocedure 0-10 visual analog scale (VAS; 0 = no pain, 10 = excruciating pain) for anticipated transabdominal and transcervical CVS-related pain. After the procedure, patients completed a VAS for perceived pain.

RESULTS

One hundred twenty-one women underwent transabdominal (n = 98) or transcervical (n = 23) CVS. Anticipated pain was 4.5 +/- 2.0, which was similar in patients who ultimately underwent transabdominal (score, 4.6 +/- 3.8) or transcervical (score, 4.1 +/- 2.2) CVS. Postprocedure perceived pain was similar for transabdominal CVS in women with an abdominal wall thickness of <4 cm (score, 2.3 +/- 0.8) and transcervical CVS (score, 2.6 +/- 2.2) but was significantly greater for transabdominal CVS among women with an abdominal wall thickness of > or =4 cm (score, 5.6 +/- 1.2; P < .0001) and nulliparous women who had transcervical CVS (score, 4.3 +/- 2.1; P = .01).

CONCLUSION

Transabdominal CVS is more painful in heavier women, and transcervical CVS is more painful in nulliparous women.

摘要

目的

本研究旨在比较经腹绒毛取样（CVS）和经宫颈绒毛取样相关的预期疼痛和实际疼痛。

研究设计

接受绒毛取样的单胎妊娠女性在术前完成一份0-10视觉模拟量表（VAS；0=无疼痛，10=剧痛），以评估经腹和经宫颈绒毛取样相关的预期疼痛。术后，患者完成一份VAS以评估实际疼痛。

结果

121名女性接受了经腹（n=98）或经宫颈（n=23）绒毛取样。预期疼痛为4.5±2.0，最终接受经腹（评分，4.6±3.8）或经宫颈（评分，4.1±2.2）绒毛取样的患者中预期疼痛相似。术后，腹壁厚度<4cm的女性经腹绒毛取样的实际疼痛（评分，2.3±0.8）与经宫颈绒毛取样（评分，2.6±2.2）相似，但腹壁厚度≥4cm的女性经腹绒毛取样的实际疼痛显著更高（评分，5.6±1.2；P<.0001），经宫颈绒毛取样的未生育女性实际疼痛也更高（评分，4.3±2.1；P=.01）。