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台湾一家三级医学中心 30 年羊膜穿刺术经验概述。

An overview of a 30-year experience with amniocentesis in a single tertiary medical center in Taiwan.

机构信息

Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2012 Jun;51(2):206-11. doi: 10.1016/j.tjog.2012.04.007.

Abstract

OBJECTIVE

Amniocentesis is a popular and effective prenatal diagnostic tool for chromosomal disorders. It is well-established that the risk of chromosomal abnormalities increases with maternal age; however, other related indications are seldom reported. Herein, we report our 30-year experience with amniocentesis from a single medical center, focusing on the indications and rates of abnormality.

MATERIAL AND METHODS

A retrospective review of 16,749 pregnant women in the mid-trimester between January 1981 and December 2010 was conducted. The medical records were analyzed.

RESULTS

The indications for amniocentesis were advanced maternal age (≥ 34 years old) (n=10,970, 65.5%), increasing-risk maternal triple-marker Down's screening test (≥ 1/270) (n=2090, 12.5%), history of abnormal offspring birth (n=792, 4.7%), abnormal ultrasound findings (n=484, 2.9%), parent with abnormal karyotype (n=252, 1.5%), family history of chromosomal abnormality (n=183, 1.1%), drug and radiation exposure (n=165), abnormal chorionic villus sampling (CVS) results (n=25), intrauterine fetal death (n=50), and other non-specific causes (n=1662, 9.9%). The rate of abnormality for each indication was 16% in the abnormal CVS group, 12% in the intrauterine fetal death group, 11.5% for parental chromosomal abnormality, 8.7% in the abnormal ultrasound finding group, 3.0% in the increasing-risk maternal triple-marker Down's screening test group, 2.5% in the advanced maternal age group, 1.5% for other non-specific causes, 1.4% for history of abnormal offspring birth, and 1.1% for family history of chromosomal abnormality.

CONCLUSIONS

Both parents with abnormal karyotype and abnormal ultrasound findings are indications for which consideration of further amniocentesis is highly recommended.

摘要

目的

羊膜穿刺术是一种用于诊断染色体疾病的常用且有效的产前诊断工具。众所周知,染色体异常的风险随着母亲年龄的增长而增加;然而,其他相关的指征很少有报道。在此,我们报告了单中心 30 年来的羊膜穿刺术经验,重点介绍了指征和异常率。

材料与方法

对 1981 年 1 月至 2010 年 12 月期间的 16749 例中期妊娠孕妇进行回顾性分析。分析了病历资料。

结果

羊膜穿刺术的指征为高龄产妇(≥34 岁)(n=10970,65.5%)、唐氏筛查高危(≥1/270)(n=2090,12.5%)、异常胎儿分娩史(n=792,4.7%)、超声异常(n=484,2.9%)、父母染色体异常(n=252,1.5%)、家族性染色体异常病史(n=183,1.1%)、药物和辐射接触(n=165)、绒毛膜绒毛取样(CVS)异常(n=25)、胎儿宫内死亡(n=50)和其他非特异性原因(n=1662,9.9%)。异常 CVS 组的异常率为 16%,宫内胎儿死亡组为 12%,父母染色体异常组为 11.5%,超声异常组为 8.7%,唐氏筛查高危组为 3.0%,高龄产妇组为 2.5%,其他非特异性原因组为 1.5%,异常胎儿分娩史组为 1.4%,家族性染色体异常病史组为 1.1%。

结论

父母双方染色体异常和超声异常均为进一步羊膜穿刺术的指征。

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