Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
J Perinat Med. 2020 Dec 9;49(4):474-479. doi: 10.1515/jpm-2020-0430. Print 2021 May 26.
To compare the rate of fetal loss in pregnancy after second trimester amniocentesis between procedures performed by experts and non-experts and to assess other pregnancy complications as secondary outcomes.
A retrospective cohort study was performed on singleton pregnancies that underwent mid-trimester amniocenteses in a single institution. The fetal loss rates of procedures performed by experts and non-experts were collected and analyzed. Other adverse pregnancy outcomes were also examined.
In total, 14,450 amniocenteses were performed during the study period. These included 11,357 (78.6%) procedures in the group expert operators and 3,093 (21.4%) procedures in the group non-expert operators. In the non-expert group, the fetal loss rate was slightly increased but not significantly (p=0.24).In addition, the higher number of spontaneous abortions was associated with blood-stained amniotic fluid sample (p<0.001; RR=9.28). Multiple needle insertions also increased in the non-expert group significantly. However, no difference in pregnancy outcomes was found between in single and multiple needle insertions.
The amniocentesis procedures performed by the non-experts was not increase the fetal loss rate. However, the other adverse pregnancy outcomes, including preterm birth, low birth weight and fetal growth restriction were significantly increased in the non-expert group.
比较专家和非专家进行的中孕期羊膜穿刺术后的胎儿丢失率，并评估其他妊娠并发症作为次要结局。
对单胎妊娠在单家机构行中孕期羊膜穿刺术的患者进行回顾性队列研究。收集并分析专家和非专家进行的操作的胎儿丢失率。还检查了其他不良妊娠结局。
在研究期间共进行了 14450 次羊膜穿刺术。其中专家操作人员组进行了 11357 次（78.6%），非专家操作人员组进行了 3093 次（21.4%）。在非专家组中，胎儿丢失率略有增加，但无统计学意义（p=0.24）。此外，血性羊水样本与更多的自然流产有关（p<0.001；RR=9.28）。非专家组的多次针插入也明显增加。然而，单次和多次针插入之间的妊娠结局无差异。
非专家进行的羊膜穿刺术并未增加胎儿丢失率。然而，非专家组的其他不良妊娠结局，包括早产、低出生体重和胎儿生长受限的发生率显著增加。
