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经皮超声引导下胎儿血液采样:前100例经验

Percutaneous ultrasound-guided fetal blood sampling: experience in the first 100 cases.

作者信息

Hsieh F J, Ko T M, Chang F M, Chen H Y, Kao M L, Furng M H

出版信息

Taiwan Yi Xue Hui Za Zhi. 1989 Feb;88(2):137-42.

PMID:2671256
Abstract

Percutaneous ultrasound-guided fetal blood sampling was performed on 100 pregnancies with various fetal problems. Our technique involved the use of a 45 degree needle guide attached to a sector probe. Their gestational ages ranged from 17-38 weeks, mostly over 20-35 weeks. Seventy percent of cases were successful at the first sampling and 33% of cases had bleeding from the punctured cord. In 43 cases, a positive diagnosis was established after ultrasound-guided fetal blood sampling, including 25 Hemoglobin Bart's hydrops fetalis, 2 beta-thalassemia major, 1 hemophilia, 1 rubella infection, 1 syphilis and 13 chromosome aberrations. There were 33 survivors in this series. Seven anomalous fetuses ended in intrauterine deaths. Sixty cases resulted in neonatal deaths after spontaneous or induced labors. No fetal loss occurred in 25 normal fetuses. One fetal loss was probably related to the procedure (fetal loss rate 1/100). No immediate fetal death after sampling procedure was noted. In conclusion, ultrasound-guided fetal blood sampling had reasonable safety and technical feasibility. More common use of this technique in fetal investigations is justified and expected.

摘要

对100例存在各种胎儿问题的妊娠进行了经皮超声引导下的胎儿采血。我们的技术包括使用连接在扇形探头上的45度针引导器。其孕周范围为17至38周,大多在20至35周以上。70%的病例首次采样成功,33%的病例穿刺脐带后出血。在43例病例中,经超声引导下的胎儿采血后确诊,其中包括25例巴氏水肿胎儿血红蛋白病、2例重型β地中海贫血、1例血友病、1例风疹感染、1例梅毒和13例染色体异常。本系列中有33例存活。7例异常胎儿死于宫内。60例在自然分娩或引产术后导致新生儿死亡。25例正常胎儿未发生胎儿丢失。1例胎儿丢失可能与操作有关(胎儿丢失率1/100)。采样术后未发现即刻胎儿死亡。总之,超声引导下的胎儿采血具有合理的安全性和技术可行性。该技术在胎儿检查中更广泛的应用是合理且值得期待的。

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