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1342例胎儿脐血取样操作作为高危妊娠护理的一个组成部分的指征。

Indications of 1342 fetal cord blood sampling procedures performed as an integral part of high risk pregnancy care.

作者信息

Deka Deepika, Dadhwal Vatsla, Roy Kumar Kallol, Malhotra Neena, Vaid Arvind, Mittal Suneeta

机构信息

Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, Room No 3073, 3rd Floor Teaching Block, Ansari Nagar, New Delhi, 110029 India.

出版信息

J Obstet Gynaecol India. 2012 Feb;62(1):20-4. doi: 10.1007/s13224-012-0152-x. Epub 2012 Apr 20.

Abstract

BACKGROUND

Fetal umbilical cord blood sampling is now being performed worldwide, using an ultrasound guided technique, for prenatal diagnosis in pregnancies at high risk for several congenital and genetic defects in the fetus. Awareness of feasibility of the procedure and indications for the same should be known to every obstetrician.

AIMS AND OBJECTIVES

To study the indications for Fetal Cord Blood Sampling in high risk pregnancy patients in the last 20 years at a tertiary referral center in India.

MATERIALS AND METHODS

Women referred to the Fetal Medicine Clinic for fetal blood sampling from January 1990 to November 2009, were assessed. An informed consent was taken. Under continuous ultrasound guidance, a 22 gauge long spinal needle was inserted through the maternal abdomen and uterine wall into the umbilical cord, and about 2-4 ml of blood, depending on the indication was aspirated by syringe. The various indications for fetal blood sampling in 1342 women were analyzed.

RESULTS

Cord blood sampling was performed for the following indications: Hb in Rh Isoimmunized pregnancies-553 cases, Chromosomal analysis-427 cases, non-immune hydrops/pleural effusion/ascites-cases 88, Congenital Infections-131 cases, Intrauterine Growth Restriction-51 cases, Thalassemia-53 cases, Hemophilia-36 cases, and for Thyroid function test for fetal goiter in 3 cases, in total 1,342 women.

CONCLUSION

There were several absolute indications for fetal cord blood sampling in high risk pregnant women, to provide state-of-the-art information on the health of the fetus. Awareness of the procedure and indications for the same should be known to every obstetrician as it is technically feasible, expertise is available in India; so that women who require the procedure may be referred in time.

摘要

背景

目前,在全球范围内,胎儿脐带血采样正采用超声引导技术进行,用于对胎儿存在多种先天性和遗传性缺陷的高危妊娠进行产前诊断。每位产科医生都应了解该操作的可行性及适应证。

目的

研究印度一家三级转诊中心过去20年高危妊娠患者进行胎儿脐带血采样的适应证。

材料与方法

对1990年1月至2009年11月转诊至胎儿医学诊所进行胎儿采血的妇女进行评估。获取知情同意书。在持续超声引导下,将一根22号长的脊椎穿刺针经孕妇腹部和子宫壁插入脐带,根据适应证用注射器抽取约2 - 4毫升血液。对1342名妇女进行胎儿采血的各种适应证进行了分析。

结果

进行脐带血采样的适应证如下:Rh血型免疫妊娠中的血红蛋白检测 - 553例,染色体分析 - 427例,非免疫性水肿/胸腔积液/腹水 - 88例,先天性感染 - 131例,宫内生长受限 - 51例,地中海贫血 - 53例,血友病 - 36例,以及3例胎儿甲状腺肿的甲状腺功能检测,总计1342名妇女。

结论

高危孕妇进行胎儿脐带血采样有多种绝对适应证,以提供有关胎儿健康的最新信息。每位产科医生都应了解该操作及其适应证,因为它在技术上是可行的,印度也有相关专业技术;以便及时转诊需要该操作的妇女。

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