Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY.
Am J Obstet Gynecol. 2013 Oct;209(4):377.e1-3. doi: 10.1016/j.ajog.2013.05.046.
Our objective was to determine the impact of disclosure of echogenic intracardiac focus (EIF) on the rate of amniocentesis in women who have undergone sequential testing.
This was a retrospective study of women who had sequential testing for Down syndrome from 2009 through 2011. The Down syndrome risk was doubled in pregnancies with EIF, consistent with counseling provided to patients. In the control group Down syndrome risk was based on sequential testing. Within risk categories (1 in <250, 251-1000, 1001-5000, >5000) rates of amniocentesis with and without documented EIF were compared using Fisher exact test.
In all, 4429 women at a median maternal age were included, including 229 with EIF (5.2%). In those at highest Down syndrome risk (1 in <250), rates of amniocentesis were similar between the 2 groups. In those at lower levels of risk, the rate of amniocentesis was significantly higher following disclosure of EIF compared to pregnancies without EIF at similar levels of risk.
Except for those at highest risk, rates of invasive testing were significantly higher in pregnancies with isolated EIF vs those at comparable risk.
本研究旨在确定在进行序贯检测的女性中，告知心内强回声灶（EIF）对羊膜穿刺术率的影响。
这是一项回顾性研究，纳入了 2009 年至 2011 年期间进行唐氏综合征序贯检测的女性。EIF 妊娠的唐氏综合征风险增加一倍，与向患者提供的咨询一致。在对照组中，唐氏综合征风险基于序贯检测。在风险类别（<250 分之一、251-1000 分之一、1001-5000 分之一、>5000 分之一）内，使用 Fisher 精确检验比较有和无 EIF 记录的羊膜穿刺术率。
共有 4429 名中位年龄的女性纳入研究，其中 229 名女性有 EIF（5.2%）。在唐氏综合征风险最高的（<250 分之一）人群中，两组的羊膜穿刺术率相似。在较低风险人群中，与具有相似风险的无 EIF 妊娠相比，EIF 阳性妊娠的羊膜穿刺术率显著更高。
除了风险最高的人群外，EIF 阳性妊娠的侵袭性检测率显著高于风险相似的妊娠。
