Geffen Keren Tzadikevitch, Ben-Zvi Ohad, Weitzner Omer, Peleg Amir, Biron-Shental Tal, Sukenik-Halevy Rivka
Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., 44281, Kfar Saba, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Arch Gynecol Obstet. 2017 Jul;296(1):69-75. doi: 10.1007/s00404-017-4408-7. Epub 2017 May 24.
This study assessed the use and complications of late amniocentesis (AC) and analyzed factors that affect complication rate.
A retrospective analysis of 167 genetic AC performed after 24 weeks during a 10-year period in two medical centers was conducted. Data regarding the indications for AC, genetic work-up, and pregnancy outcomes were retrieved from patient medical records and telephone-based questionnaires.
Mean gestational age (GA) at the time of AC was 31.7 ± 2.7 weeks; 104 procedures were performed at ≤32 weeks, including 24 at ≤30 weeks. The overall pregnancy complication rate occurring at any time after the procedure was 6.6% (11). Of these, 4.8% (8) occurred within a month after AC, including 2.4% (4) that occurred within a week. An additional three occurred after 30 days. There were no differences in the total complication rate and in the rate of specific complications of procedures performed at ≤32 weeks or at ≤30 weeks. Maternal age did not affect outcomes. Genetic testing was abnormal in five cases (3%). Amniocyte culture failed in 3 cases (2.3%), with no technical failures in 52 chromosomal microarray tests.
The complication rate of AC performed after 24 weeks was 4.8%, which is significantly higher than that of second trimester AC. GA and maternal age did not affect the complication rate.
本研究评估了晚期羊膜腔穿刺术（AC）的使用情况及并发症，并分析了影响并发症发生率的因素。
对两个医疗中心在10年期间24周后进行的167例遗传性AC进行回顾性分析。从患者病历和电话调查问卷中获取有关AC指征、基因检查及妊娠结局的数据。
AC时的平均孕周（GA）为31.7±2.7周；104例手术在≤32周时进行，其中24例在≤30周时进行。术后任何时间发生的总体妊娠并发症发生率为6.6%（11例）。其中，4.8%（8例）在AC后1个月内发生，包括2.4%（4例）在1周内发生。另外3例在30天后发生。≤32周或≤30周进行的手术在总并发症发生率和特定并发症发生率方面无差异。产妇年龄不影响结局。5例（3%）基因检测异常。3例（2.3%）羊水细胞培养失败，52例染色体微阵列检测无技术失败。
24周后进行的AC并发症发生率为4.8%，明显高于孕中期AC。孕周和产妇年龄不影响并发症发生率。
