3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece.
Eur J Obstet Gynecol Reprod Biol. 2013 Jul;169(2):230-3. doi: 10.1016/j.ejogrb.2013.03.027. Epub 2013 May 9.
To investigate the impact of operator experience on amniocentesis-related adverse outcomes.
Retrospective study of mid-trimester amniocenteses performed by the same operator on singleton pregnancies in a single private institution during 1994-2007. Outcomes were hemorrhagic or dark amniotic fluid aspiration, insufficient volume aspiration, repeated puncture and fetal loss. Rates were estimated annually, as well as for every 10% of procedures up to the total number. The association of each outcome with epidemiological aspects was also examined.
In total, 5913 amniocenteses were performed. The overall rate of adverse outcomes was 5.4%. The total adverse outcome rate reduced from 10.2% in the first 10% of cases to 3.0% in the last 10% (P=.001). The rate of hemorrhagic fluid gradually decreased from 4.4% to 1.5% (P=.05) over the same intervals. The fetal loss rate was also reduced from 0.5% during the first half to 0.3% in the second half of the study period (P=NS). Logistic regression analysis indicated no significant correlations between adverse outcomes with any of epidemiological parameters of women undergoing amniocentesis.
Operator experience has a beneficial impact on preventing procedure-related adverse outcomes.
探讨操作人员经验对羊膜穿刺术相关不良结局的影响。
对 1994 年至 2007 年间在一家私立机构中单胎妊娠由同一名操作人员进行的中期羊膜穿刺术的回顾性研究。结局为血性或暗羊水抽吸、抽吸量不足、重复穿刺和胎儿丢失。每年以及每 10%的操作次数（直至总次数）估计发生率。还检查了每种结局与流行病学方面的关联。
共进行了 5913 次羊膜穿刺术。不良结局的总体发生率为 5.4%。不良结局的总发生率从前 10%的 10.2%降至后 10%的 3.0%（P=.001）。血性羊水的发生率在同一时期从 4.4%逐渐降至 1.5%（P=.05）。在研究期间的前半段，胎儿丢失率从 0.5%降至后半段的 0.3%（P=NS）。逻辑回归分析表明，与接受羊膜穿刺术的女性的任何流行病学参数相比，不良结局与操作人员经验均无显著相关性。
操作人员经验对预防与操作相关的不良结局有有益影响。
