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.
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.
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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