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双绒毛膜性双胎妊娠行羊膜腔穿刺术或绒毛活检术的产科结局。

Obstetrical Outcomes of Amniocentesis or Chorionic Villus Sampling in Dichorionic Twin Pregnancies.

机构信息

Department of Obstetrics and Gynecology, CHA Bundang Medical Center, Seongnam, Korea.

出版信息

J Korean Med Sci. 2019 May 13;34(18):e142. doi: 10.3346/jkms.2019.34.e142.

Abstract

BACKGROUND

Under certain situations, women with twin pregnancies may be counseled to undergo invasive prenatal diagnostic testing. Chorionic villus sampling and amniocentesis are the two generally performed invasive prenatal diagnostic tests. Studies comparing procedure-related fetal loss between first-trimester chorionic villus sampling and second-trimester amniocentesis in twin pregnancies are limited. This study aimed to evaluate the procedure-related fetal loss and the obstetrical outcomes of these two procedures, chorionic villus sampling and amniocentesis in twin pregnancies.

METHODS

The data from dichorionic-diamniotic twin pregnancies on which first-trimester chorionic villus sampling (n = 54) or second-trimester amniocentesis (n = 170) was performed between December 2006 and January 2017 in a single center were retrospectively analyzed. The procedure-related fetal loss was classified as loss of one or all fetuses within 4 weeks of procedure, and overall fetal loss was classified as loss of one or all fetuses during the gestation. The groups were compared with respect to the procedure-related and obstetrical outcomes.

RESULTS

The difference in proportion of procedure-related fetal loss rate (1.9% for chorionic villus sampling vs. 1.8% for amniocentesis; = 1.000) and the overall fetal loss rate (7.4% for chorionic villus sampling vs. 4.7% for amniocentesis; = 0.489) between the two groups was not significant. The mean gestational ages at delivery were not statistically significant.

CONCLUSION

Both the overall fetal loss rate and the procedure-related fetal loss rate of chorionic villus sampling and amniocentesis in dichorionic twin pregnancies had no statistical significance. Both procedures can be safely used individually.

摘要

背景

在某些情况下,双胎妊娠的女性可能会接受有创性产前诊断检测。绒毛膜绒毛取样和羊膜穿刺术是两种常用的有创性产前诊断检测。比较双胎妊娠中早孕期绒毛膜绒毛取样与中孕期羊膜穿刺术与相关胎儿丢失的研究有限。本研究旨在评估这两种方法(双胎妊娠中早孕期绒毛膜绒毛取样和中孕期羊膜穿刺术)与相关胎儿丢失和产科结局。

方法

回顾性分析 2006 年 12 月至 2017 年 1 月期间在一家中心进行的双绒毛膜-双羊膜性双胎妊娠早孕期绒毛膜绒毛取样(n=54)或中孕期羊膜穿刺术(n=170)的资料。将与操作相关的胎儿丢失定义为操作后 4 周内丢失一个或所有胎儿,总体胎儿丢失定义为妊娠期间丢失一个或所有胎儿。比较两组的与操作相关和产科结局。

结果

绒毛膜绒毛取样组与羊膜穿刺术组的与操作相关的胎儿丢失率(1.9%比 1.8%;=1.000)和总体胎儿丢失率(7.4%比 4.7%;=0.489)差异无统计学意义。两组的分娩时平均孕龄无统计学差异。

结论

双绒毛膜性双胎妊娠中绒毛膜绒毛取样和羊膜穿刺术的总体胎儿丢失率和与操作相关的胎儿丢失率均无统计学意义。两种方法均可单独安全使用。

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Obstet Gynecol Sci. 2019 Mar;62(2):93-102. doi: 10.5468/ogs.2019.62.2.93. Epub 2019 Feb 25.
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Amniocentesis and chorionic villus sampling for prenatal diagnosis.用于产前诊断的羊膜穿刺术和绒毛取样。
Cochrane Database Syst Rev. 2017 Sep 4;9(9):CD003252. doi: 10.1002/14651858.CD003252.pub2.
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The outcome of twin pregnancies discordant for trisomy 21.21三体综合征不一致的双胎妊娠结局。
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