Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Public Health, Tzu-Chi University, Hualien, Taiwan.
J Formos Med Assoc. 2019 Jul;118(7):1107-1113. doi: 10.1016/j.jfma.2019.03.006. Epub 2019 Mar 27.
To assess the complication rates following chorionic villus sampling (CVS) and midtrimester amniocentesis in Taiwan.
This is a national registry-based cohort study from Taiwan. We included all women with singleton pregnancies who received either CVS (n = 1409) or midtrimester amniocentesis (n = 250,566) during 2006-2012. We assessed preterm premature rupture of membranes (PPROM), intrauterine fetal demise (IUFD), infection and spontaneous abortion (SA) that occurred within fourteen days after the procedures. We also assessed the risks of preterm delivery and miscarriage before 24 gestational weeks after amniocentesis. These complications were collected from the Genetic Disease Database of the Ministry of Health and Welfare, Taiwan National Birth Certificate Registry, and the Taiwan National Health Insurance Database. Pearson χ tests were used to compare the distributions between groups.
For patients who underwent midtrimester amniocentesis, the rates of PPROM, IUFD, infection and SA within fourteen days were 0.24%, 0.11%, 0.05%, and 0.05%, respectively. Women with a normal fetal karyotype had a preterm birth rate (<37 gestational weeks) of 9.38%. The miscarriage rate (<24 gestational weeks) was 0.68%, which was 0.22% higher than those who did not receive the invasive procedures (p < 0.0001). After CVS, the IUFD rate was 1.68%, and the SA rate within fourteen days was 0.77%.
The use of our large cohort demonstrated that the procedure-related complication rates were comparable to recent review or meta-analysis. This dataset might facilitate counselling in women who consider invasive genetic diagnostic procedures.
评估台湾绒毛膜绒毛取样（CVS）和中期羊膜穿刺术的并发症发生率。
这是一项基于台湾全国注册库的队列研究。我们纳入了 2006 年至 2012 年期间接受过 CVS（n=1409）或中期羊膜穿刺术（n=250566）的单胎妊娠妇女。我们评估了术后 14 天内发生的早产胎膜早破（PPROM）、胎儿宫内死亡（IUFD）、感染和自然流产（SA）。我们还评估了羊膜穿刺术后 24 孕周前早产和流产的风险。这些并发症是从台湾卫生福利部遗传疾病数据库、台湾国家出生证登记处和台湾国家健康保险数据库中收集的。采用 Pearson χ 检验比较组间分布。
对于接受中期羊膜穿刺术的患者，PPROM、IUFD、感染和 SA 的 14 天内发生率分别为 0.24%、0.11%、0.05%和 0.05%。核型正常的胎儿早产率（<37 孕周）为 9.38%。流产率（<24 孕周）为 0.68%，高于未行侵入性操作的患者（p<0.0001），高出 0.22%。CVS 后 IUFD 发生率为 1.68%，14 天内 SA 发生率为 0.77%。
我们的大型队列研究结果表明，该操作相关并发症发生率与近期综述或荟萃分析相当。该数据集可能有助于对考虑行侵入性遗传诊断操作的女性进行咨询。
