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孕中期遗传羊膜腔穿刺术中胎儿心动过缓的发生率及胎盘损伤对胎儿心率的影响。

Incidence of fetal bradycardia and effect of placental injury on fetal heart rate during second-trimester genetic amniocentesis.

作者信息

Hanprasertpong T, Petpichetchian C, Ponglopisit S, Suksai M, Kor-Anantakul O, Geater A, Pruksanusak N, Hanprasertpong J

机构信息

a Department of Obstetrics and Gynecology , Faculty of Medicine, Prince of Songkla University , Hatyai, Songkhla , Thailand.

b Epidemiology Unit, Faculty of Medicine, Prince of Songkla University , Hatyai, Songkhla , Thailand.

出版信息

J Obstet Gynaecol. 2016 May;36(4):476-8. doi: 10.3109/01443615.2015.1086733. Epub 2015 Oct 29.

Abstract

A prospective study was conducted for comparing the incidence of fetal bradycardia and level of fetal heart rate change following a second-trimester genetic amniocentesis with and without placental injury. A total of 257 and 495 participants in injured and non-injured groups were analysed. The incidence of fetal bradycardia following amniocentesis was not statistically different between the two groups (1.17%, [95% CI 0.24, 3.37] and 0.20%, [95% CI 0.005, 1.12]) in injured and non-injured placenta groups, respectively; p = 0.118). The mean change in baseline fetal heart rate before and after amniocentesis was also not significantly different between the two groups (p = 0.844). No fetal death or pregnancy loss occurred within 4 weeks after the procedure. All 4 bradycardia participants were normal and healthy and had an appropriate weight for their gestational age. We conclude that placental injury during a second-trimester genetic amniocentesis due to advanced maternal age poses only a low risk of fetal bradycardia, and there is no evidence of differences between subjects with injured and non-injured placenta in the changes in fetal heart rate.

摘要

一项前瞻性研究旨在比较孕中期基因羊膜穿刺术导致胎盘损伤与未导致胎盘损伤情况下胎儿心动过缓的发生率及胎儿心率变化水平。对损伤组和未损伤组的257名和495名参与者进行了分析。羊膜穿刺术后胎儿心动过缓的发生率在损伤胎盘组和未损伤胎盘组之间无统计学差异,分别为1.17%,[95%可信区间0.24, 3.37]和0.20%,[95%可信区间0.005, 1.12];p = 0.118)。羊膜穿刺术前后胎儿基线心率的平均变化在两组之间也无显著差异(p = 0.844)。术后4周内未发生胎儿死亡或妊娠丢失。所有4例心动过缓参与者均正常健康,且其体重与孕周相符。我们得出结论,高龄孕妇在孕中期基因羊膜穿刺术期间发生胎盘损伤仅导致胎儿心动过缓的低风险,且没有证据表明胎盘损伤与未损伤的受试者在胎儿心率变化方面存在差异。

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