Kalogiannidis I, Prapa S, Dagklis T, Karkanaki A, Petousis S, Prapas Y, Prapas N
Iakentro, Advanced Medical Center, Thessaloniki, Greece.
Clin Exp Obstet Gynecol. 2011;38(3):239-42.
Amniocentesis-related adverse outcomes in singleton pregnancies and possible risk factors for fetal loss after mid-trimester amniocentesis performed in a single institution were investigated.
Amniocentesis-related adverse outcomes such as insufficient aspiration of amniotic fluid (AF), repeated puncture, and aspiration of hemorrhagic AF after mid-trimester amniocentesis were reviewed, while special consideration was given according to the placental location. Fetal loss rate up to 24 weeks of gestation and risk factors related to fetal losses were also investigated.
5,948 cases with the inclusion criteria were analyzed. Advanced maternal age was the most common indication (53%) for amniocentesis. A need for repeated puncture was overall 2.1% (n = 128) and was associated with a fundal placental location. Aspiration of hemorrhagic amniotic fluid was observed in 3.7% (n = 222) and was significantly associated with an anterior or fundal placental position. Fetal loss rate was 0.3% and there was no relationship with advanced maternal age (> or = 35 years), gestational age at amniocentesis > 18 weeks, repeated procedure, aspiration of hemorrhagic AF or placental location.
Anterior or fundal placental position is a risk factor for amniocentesis-related adverse outcomes, however without significant contribution to the fetal losses. Placental location, advanced maternal age, amniocentesis gestational age > 18 weeks, and the procedure's adverse outcomes seem to have no impact on fetal loss rate.
调查单胎妊娠中与羊膜腔穿刺术相关的不良结局以及孕中期在单一机构进行羊膜腔穿刺术后胎儿丢失的可能危险因素。
回顾孕中期羊膜腔穿刺术后与羊膜腔穿刺术相关的不良结局，如羊水抽吸不足、重复穿刺和血性羊水抽吸，并根据胎盘位置给予特别考虑。还调查了妊娠24周前的胎儿丢失率以及与胎儿丢失相关的危险因素。
分析了5948例符合纳入标准的病例。高龄产妇是羊膜腔穿刺术最常见的指征（53%）。重复穿刺的总体发生率为2.1%（n = 128），与胎盘位于宫底有关。血性羊水抽吸率为3.7%（n = 222），与胎盘位于前壁或宫底显著相关。胎儿丢失率为0.3%，与高龄产妇（≥35岁）、羊膜腔穿刺术时的孕周>18周、重复操作、血性羊水抽吸或胎盘位置无关。
胎盘位于前壁或宫底是与羊膜腔穿刺术相关不良结局的危险因素，但对胎儿丢失无显著影响。胎盘位置、高龄产妇、羊膜腔穿刺术孕周>18周以及该操作的不良结局似乎对胎儿丢失率没有影响。
