Pruggmayer M, Bartels I, Rauskolb R, Osmers R
Institut für Humangenetik der Univ. Göttingen.
Geburtshilfe Frauenheilkd. 1990 Oct;50(10):810-2. doi: 10.1055/s-2008-1026369.
Though the risk of abortion after amniocentesis in singleton pregnancies is well known, that for twin pregnancies is still unclear. A retrospective study was performed during December 1985 to May 1989 on all twin pregnancies that had undergone an amniocentesis, because of advanced maternal age. Out of the 33 patients aged greater than or equal to 35 years with viable and sonographically normal foetuses at the time of amniocentesis, three aborted spontaneously within 28 weeks of gestation, representing a risk of abortion after amniocentesis of 9.1%; using a cut-off at 20 weeks of gestation, only two patients aborted, giving a risk figure of 6.1%. This is 3.6 times higher than in singleton pregnancies (1.7%). However, to evaluate the procedure-related risk of amniocentesis, the age-dependent spontaneous abortion risk in twin pregnancies has to be considered. Accepting a spontaneous abortion risk of 4.5% after 16 weeks of gestation we have to calculate an amniocentesis-dependent risk of 1.6% up to the 20th week of gestation. It is essential, that the obviously higher genetic risk in twin pregnancies and the risk of procedure should be discussed carefully, before a patient with a twin pregnancy is advised to undergo genetic amniocentesis.
虽然单胎妊娠羊膜腔穿刺术后的流产风险已为人熟知，但双胎妊娠的该风险仍不明确。1985年12月至1989年5月期间，对所有因孕妇年龄较大而接受羊膜腔穿刺术的双胎妊娠进行了一项回顾性研究。在33例年龄大于或等于35岁、羊膜腔穿刺术时胎儿存活且超声检查正常的患者中，3例在妊娠28周内自然流产，羊膜腔穿刺术后的流产风险为9.1%；以妊娠20周为界，只有2例患者流产，风险率为6.1%。这比单胎妊娠（1.7%）高出3.6倍。然而，为了评估羊膜腔穿刺术与手术相关的风险，必须考虑双胎妊娠中与年龄相关的自然流产风险。接受妊娠16周后4.5%的自然流产风险，我们必须计算出直至妊娠20周时与羊膜腔穿刺术相关的风险为1.6%。在建议双胎妊娠患者接受基因羊膜腔穿刺术前，必须仔细讨论双胎妊娠中明显更高的遗传风险和手术风险。
