Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Prenat Diagn. 2020 Sep;40(10):1330-1337. doi: 10.1002/pd.5783. Epub 2020 Aug 4.
To assess the amniocentesis-related pregnancy loss rate and preterm birth rate among twin pregnancies undergoing amniocentesis.
A retrospective cohort study was conducted at a tertiary center. The study group included twin pregnancies undergoing amniocentesis during 16 to 22 weeks of gestation. The control group was those not undergoing amniocentesis. All amniocenteses were performed by the MFM specialists. The main outcomes were the rate of pregnancy loss (before 24 weeks) and preterm birth.
A total of 332 cases in the study group and 1188 controls were analyzed. The percentages of maternal age ≥35 years, high parity, and cases complicated with medical diseases were significantly higher in the study group. The pregnancy loss rate after the procedure tended to be higher, but not significant, in the study group (3.0% vs 2.2% P = .383). Likewise, the rate of preterm birth in the study group was higher, but not significant (70.5% vs 66.0% P = .130). Logistic regression analysis to adjust confounding factors showed no significance of amniocentesis on pregnancy loss and preterm birth.
Though amniocentesis in twin pregnancies has theoretical risk of pregnancy loss, it is relatively safe when performed by maternal-fetal medicine specialists. This information is useful for counseling, especially when performed by experienced hands.
评估行羊膜穿刺术的双胎妊娠的羊膜穿刺相关流产率和早产率。
这是一项在三级中心进行的回顾性队列研究。研究组包括在 16 至 22 周妊娠期间行羊膜穿刺术的双胎妊娠。对照组为未行羊膜穿刺术的妊娠。所有的羊膜穿刺术均由母胎医学专家进行。主要结局为流产（24 周前）和早产的发生率。
研究组共 332 例，对照组 1188 例。研究组的母亲年龄≥35 岁、多胎妊娠和合并内科疾病的比例明显较高。研究组术后流产率虽有升高趋势，但无统计学意义（3.0%比 2.2%，P=.383）。同样，研究组早产率也较高，但无统计学意义（70.5%比 66.0%，P=.130）。经调整混杂因素的 logistic 回归分析显示，羊膜穿刺术对流产和早产无显著影响。
虽然羊膜穿刺术在双胎妊娠中有理论上的流产风险，但当由母胎医学专家进行时，它相对安全。该信息有助于指导临床决策，特别是当由经验丰富的医生进行时。
