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血友病携带者如何经历产前诊断(PND)?携带者对羊膜穿刺术和胎儿血液取样的即时及后续反应。

How do carriers of hemophilia experience prenatal diagnosis (PND)? Carriers' Immediate and later reactions to amniocentesis and fetal blood sampling.

作者信息

Ljung R, McNeil T, Tedgård E, Schẃartz M

机构信息

Department of Pediatrics, University of Lund, Malmö, General Hospital, Sweden.

出版信息

Acta Paediatr Scand. 1989 Sep;78(5):692-700. doi: 10.1111/j.1651-2227.1989.tb11128.x.

Abstract

A semistructured personal interview was performed with 29 carriers of hemophilia A or B, 1-5 years after a pregnancy in which prenatal diagnosis (PND) was performed by fetal blood sampling. Fetal blood sampling by fetoscopy was significantly more often reported by the women to the more trying than expected than was ultrasound-guided heart puncture. Of 29 women 13 was classified as having experienced the PND process (amniocentesis and fetal blood sampling) as distressing, having had mental or psychosomatic symptoms associated with it. All of the women who had abortion/miscarriage after PND reported a very high frequency of psychological sequelae during the 6 months that followed PND. Of 22 women who continued their pregnancy with a healthy fetus after PND 8 experienced the period until delivery as trying and felt that their emotional and somatic status influenced their daily life activities. This was particularly common among women who after fetoscopy received routine profylactic terbutalin treatment and had continuous sickleave until the 36th gestational week, 17/29 would consider going through PND in the future. Qualified psychological assistance must be offered both before and after PND.

摘要

对29名甲型或乙型血友病携带者进行了半结构化个人访谈,访谈时间为她们接受胎儿采血进行产前诊断(PND)后的1至5年。与超声引导下心脏穿刺相比,更多女性报告通过胎儿镜进行胎儿采血比预期更具挑战性。29名女性中,有13名被归类为经历了痛苦的PND过程(羊膜穿刺术和胎儿采血),并伴有与之相关的精神或身心症状。所有在PND后流产/ miscarriage的女性在PND后的6个月内都报告了非常高频率的心理后遗症。在22名PND后怀有健康胎儿并继续妊娠的女性中,有8名在分娩前这段时间感到艰难,并认为自己的情绪和身体状况影响了日常生活活动。这在接受胎儿镜检查后接受常规预防性特布他林治疗并持续病假至妊娠第36周的女性中尤为常见,29名中有17名会考虑未来再次接受PND。PND前后都必须提供专业的心理援助。 (注:原文中miscarriage未翻译,因为它是医学术语“流产”的英文,这里保留英文更准确;另外“prophylactic”应改为“prophylactic”,译文已修正为“预防性的” )

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