Corrado F, Cannata M L, La Galia T, Magliarditi M, Imbruglia L, D'anna R, Carlo Stella N
Department of Obstetrics and Gynecology, University of Messina, Messina, Italy.
J Obstet Gynaecol. 2012 Feb;32(2):117-9. doi: 10.3109/01443615.2011.633717.
To determine the institutional pregnancy complications rate associated with genetic amniocentesis and ascertain whether procedural variables or pre-existing factors may determine an increased risk of having a procedural-related fetal loss, we retrospectively evaluated all the consecutive amniocentesis, with known pregnancy outcome (n = 2990), performed between January 2001 and December 2009 by two very experienced clinicians. The patients who had counselling in the same period but declined to undergo amniocentesis represent the control group (n = 487). A total of 30 fetal losses occurred within 24 weeks' gestation (1%), while in the control group, we had four losses (0.8%). Procedural variables (transplacental sample, multiple needle insertions and gestational age) were not found to be predictive of increased fetal loss rate. Previous vaginal bleeding increased the risk of pregnancy loss after amniocentesis with an OR 4.1 (95% CI 2.0-8.7); on the contrary, a history of two or more miscarriages is not associated with a greater fetal loss rate, while the increased percentage (OR 3.4, 95% CI 1.2-9.0) in patients affected by uterine myoma appears connected, after the comparison with the control group, with the presence of fibroids rather than procedure.
为了确定与遗传羊膜腔穿刺术相关的机构妊娠并发症发生率，并确定操作变量或既往因素是否可能导致与操作相关的胎儿丢失风险增加，我们回顾性评估了2001年1月至2009年12月期间由两位经验丰富的临床医生进行的所有连续羊膜腔穿刺术（已知妊娠结局，n = 2990）。同期接受咨询但拒绝接受羊膜腔穿刺术的患者作为对照组（n = 487）。共有30例胎儿在妊娠24周内丢失（1%），而对照组有4例丢失（0.8%）。未发现操作变量（经胎盘取样、多次穿刺和孕周）可预测胎儿丢失率增加。既往阴道出血会增加羊膜腔穿刺术后妊娠丢失的风险，比值比为4.1（95%可信区间2.0 - 8.7）；相反，有两次或更多次流产史与更高的胎儿丢失率无关，而与对照组相比，子宫肌瘤患者中增加的百分比（比值比3.4，95%可信区间1.2 - 9.0）似乎与肌瘤的存在有关，而非与操作有关。
