羊膜穿刺术和绒毛取样术在双胎妊娠中的应用：哪种是最佳的取样技术？

Amniocentesis and chorionic villus sampling in twin gestations: which is the best sampling technique?

机构信息

Department of Obstetrics and Gynecology, St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.

出版信息

Am J Obstet Gynecol. 2010 Apr;202(4):365.e1-5. doi: 10.1016/j.ajog.2009.11.016. Epub 2010 Jan 13.

DOI:10.1016/j.ajog.2009.11.016

PMID:20060095

Abstract

OBJECTIVE

To compare the fetal loss rate <24 weeks and the preterm premature rupture of the membranes <34 weeks' gestation according to type of invasive procedure and to sampling techniques in twins.

STUDY DESIGN

Retrospective cohort study of 204 twin pregnancies, who underwent amniocentesis (100) or chorionic villus sampling (104).

RESULTS

Fetal loss rate <4 weeks was 3.85% in chorionic villus sampling group and 4.00% in amniocentesis group (P value not significant). According to sampling technique, fetal loss rate was 4.17% (chorionic villus sampling 1 puncture), 2.70% (amniocentesis 1 puncture), 3.75% (chorionic villus sampling 2 punctures), and 4.76% (amniocentesis 2 punctures), (P values not significant). Preterm premature rupture of the membranes rate <34 weeks was 8.2% chorionic villus sampling group and 10% in amniocentesis group (P value not significant). According to sampling technique, preterm premature rupture of the membranes rate was 12.5% (chorionic villus sampling 1 puncture), 8.1% (amniocentesis 1 puncture), 6.9% (chorionic villus sampling 2 punctures), and 11.1 % (amniocentesis 2 punctures), (P values not significant).

CONCLUSION

Double entry technique does not affect significantly the outcomes evaluated, in both amniocentesis and chorionic villus sampling.

摘要

目的

比较经侵袭性操作和取样技术诊断的双胎妊娠 24 周前胎儿丢失率和<34 周胎膜早破率。

研究设计

回顾性队列研究 204 例双胎妊娠，行羊膜腔穿刺术（100 例）或绒毛膜活检术（104 例）。

结果

绒毛膜活检组 4 周内胎儿丢失率为 3.85%，羊膜腔穿刺组为 4.00%（P 值无显著差异）。根据取样技术，胎儿丢失率分别为绒毛膜活检组 1 穿刺 4.17%，羊膜腔穿刺组 1 穿刺 2.70%，绒毛膜活检组 2 穿刺 3.75%，羊膜腔穿刺组 2 穿刺 4.76%（P 值无显著差异）。<34 周胎膜早破率绒毛膜活检组为 8.2%，羊膜腔穿刺组为 10%（P 值无显著差异）。根据取样技术，胎膜早破率分别为绒毛膜活检组 1 穿刺 12.5%，羊膜腔穿刺组 1 穿刺 8.1%，绒毛膜活检组 2 穿刺 6.9%，羊膜腔穿刺组 2 穿刺 11.1%（P 值无显著差异）。