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羊膜腔穿刺和脐带穿刺后的胎儿-母体输血。

Fetomaternal transfusion after amniocentesis and cordocentesis.

机构信息

Departments of Obstetrics and Gynecology, Faculty of Medicine, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Semmelweis u. 1., Szeged 6725, Hungary.

出版信息

Ir J Med Sci. 2011 Sep;180(3):697-701. doi: 10.1007/s11845-010-0663-3. Epub 2010 Dec 30.

DOI:10.1007/s11845-010-0663-3
PMID:21190089
Abstract

OBJECTIVE

To compare the extent of fetomaternal transfusion after amniocentesis and cordocentesis.

SETTING

Three-hundred and forty-five amniocentesis and 268 cordocentesis were performed for genetic indications. The extent of fetomaternal transfusion was calculated on the basis of the maternal serum alpha-fetoprotein level changes.

RESULTS

The mean fetomaternal transfusion was 6.3 and 62 μL in the amniocentesis and cordocentesis groups, respectively. Transplacental needle passage and longer procedural time were risk factors for fetomaternal transfusion. The frequency of transplacental passage was higher and the procedural time was longer in the cordocentesis group. The fetal loss rate was 1.17% after amniocentesis and 1.2% after cordocentesis, respectively.

CONCLUSIONS

Cordocentesis causes more injury to the extrafetal compartment, which results in a higher level of fetomaternal transfusion. However, though a nearly ten times higher fetomaternal transfusion was observed after cordocentesis, there was no essential difference in pregnancy outcome between the two groups.

摘要

目的

比较羊膜穿刺术和脐带穿刺术后的胎儿-母体输血程度。

背景

为了遗传诊断,共进行了 345 次羊膜穿刺术和 268 次脐带穿刺术。基于母体血清甲胎蛋白水平的变化来计算胎儿-母体输血的程度。

结果

羊膜穿刺术组和脐带穿刺术组的平均胎儿-母体输血分别为 6.3μL 和 62μL。胎盘内针道通过和较长的操作时间是胎儿-母体输血的危险因素。脐带穿刺术组的胎盘内针道通过频率更高,操作时间也更长。羊膜穿刺术后胎儿丢失率为 1.17%,脐带穿刺术后为 1.2%。

结论

脐带穿刺术对胎儿外室造成更大的损伤,导致更高程度的胎儿-母体输血。然而,尽管脐带穿刺术后观察到近十倍更高的胎儿-母体输血,但两组的妊娠结局没有本质差异。

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1
Fetomaternal transfusion after amniocentesis and cordocentesis.羊膜腔穿刺和脐带穿刺后的胎儿-母体输血。
Ir J Med Sci. 2011 Sep;180(3):697-701. doi: 10.1007/s11845-010-0663-3. Epub 2010 Dec 30.
2
Fetomaternal transfusion and pregnancy outcome after cordocentesis.脐带穿刺术后的母胎输血与妊娠结局
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Prenat Diagn. 1995 Apr;15(4):313-6. doi: 10.1002/pd.1970150403.
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[Feto-maternal transfusion following cordocentesis].[脐带穿刺术后的母胎输血]
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本文引用的文献

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Prenatal genetic testing by amniocentesis appears to result in a lower risk of fetal loss than chorionic villus sampling in singleton pregnancies achieved by intracytoplasmic sperm injection.对于通过胞浆内单精子注射实现的单胎妊娠,与绒毛取样相比,羊膜穿刺术进行产前基因检测似乎导致胎儿丢失的风险更低。
Fertil Steril. 2003 Feb;79(2):374-8. doi: 10.1016/s0015-0282(02)04578-8.
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Risk of amniocentesis in women screened positive for Down syndrome with second trimester maternal serum markers.唐氏综合征孕中期母体血清标志物筛查呈阳性的女性进行羊膜穿刺术的风险。
Prenat Diagn. 2002 Nov;22(11):1036-9. doi: 10.1002/pd.449.
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Five-year experience with midtrimester amniocentesis performed by a single group of obstetricians-gynecologists at a community hospital.
一组妇产科医生在一家社区医院进行孕中期羊膜穿刺术的五年经验。
Am J Obstet Gynecol. 2002 Jun;186(6):1130-2. doi: 10.1067/mob.2002.122987.
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Risk factors predisposing to fetal loss following a second trimester amniocentesis.孕中期羊膜腔穿刺术后导致胎儿丢失的危险因素。
BJOG. 2001 Oct;108(10):1053-6. doi: 10.1111/j.1471-0528.2001.00246.x.
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A single physician's experience with four thousand six hundred genetic amniocenteses.一位医生对4600例遗传羊膜腔穿刺术的经验。
Am J Obstet Gynecol. 2001 Aug;185(2):279-88. doi: 10.1067/mob.2001.116737.
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Fetomaternal transfusion and pregnancy outcome after cordocentesis.脐带穿刺术后的母胎输血与妊娠结局
Fetal Diagn Ther. 2001 Mar-Apr;16(2):83-9. doi: 10.1159/000053886.
8
Cordocentesis at 16-24 weeks of gestation: experience of 1,320 cases.妊娠16 - 24周时的脐带穿刺术:1320例经验
Prenat Diagn. 2000 Mar;20(3):224-8.
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Amniocentesis-related fetal loss: a cohort study.羊膜腔穿刺术相关的胎儿丢失:一项队列研究。
Obstet Gynecol. 1998 Jul;92(1):64-7. doi: 10.1016/s0029-7844(98)00125-2.
10
Fetal plasma iron and restoration of red blood cell mass after hemorrhage of the ovine fetus.绵羊胎儿出血后胎儿血浆铁与红细胞量的恢复
Am J Obstet Gynecol. 1997 Nov;177(5):1172-7. doi: 10.1016/s0002-9378(97)70036-x.