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绒毛膜绒毛取样和羊膜穿刺术后双胎妊娠的胎儿丢失:一项多中心回顾性队列研究。

Foetal loss after chorionic villus sampling and amniocentesis in twin pregnancies: A multicentre retrospective cohort study.

机构信息

Fetal Medicine Unit, Liverpool Women's Hospital, Liverpool, UK.

Harris-Wellbeing Research Centre, University of Liverpool, Liverpool, UK.

出版信息

Prenat Diagn. 2022 Nov;42(12):1554-1561. doi: 10.1002/pd.6237. Epub 2022 Sep 27.

Abstract

OBJECTIVE

We aimed to determine foetal losses for DCDA and MCDA twins following transabdominal CVS or amniocentesis performed <22+  weeks.

METHODS

Retrospective cohort study conducted in the UK and Belgium 01/01/00-01/06/20. Cases with unknown chorionicity, monochorionic complications or complex procedures were excluded. Uncomplicated DCDA and MCDA twins without invasive procedures were identified as controls. We reported foetal losses <24+  weeks and losses of genetically and structurally normal foetuses.

RESULTS

Outcomes were compared for DCDA foetuses; 258 after CVS with 3406 controls, 406 after amniocentesis with 3390 controls plus MCDA foetuses, 98 after CVS with 1124 controls, and 160 after amniocentesis with 1122 controls. There were more losses <24+  weeks with both procedures in DCDA (CVS RR 5.54 95% CI 3.38-9.08, amniocentesis RR 2.36 95% CI 1.22-4.56) and MCDA twins (CVS RR 5.14 95% CI 2.51-10.54, amniocentesis RR 7.01 95% CI 3.86-12.74). Losses of normal foetuses were comparable to controls (DCDA CVS RR 0.39 95% CI 0.05-2.83, DCDA amniocentesis RR 1.16 95% CI 0.42-3.22, MCDA CVS RR 2.3 95% CI 0.71-7.56, and MCDA amniocentesis RR 1.93 95% CI 0.59-6.38).

CONCLUSIONS

This study indicates increased foetal losses for DCDA and MCDA twins following CVS and amniocentesis with uncertain risk to normal foetuses.

摘要

目的

我们旨在确定在 22+ 周之前经腹绒毛膜取样(CVS)或羊膜穿刺术进行后 DCDA 和 MCDA 双胎的胎儿丢失率。

方法

这是一项在英国和比利时进行的回顾性队列研究,时间为 01/01/00-01/06/20。排除了绒毛膜性不明、单绒毛膜并发症或复杂操作的病例。将无侵袭性操作的单纯 DCDA 和 MCDA 双胎作为对照。我们报告了 24+ 周前的胎儿丢失和遗传及结构正常胎儿的丢失。

结果

比较了 DCDA 胎儿的结局;CVS 后有 258 例,对照组有 3406 例;羊膜穿刺后有 406 例,对照组有 3390 例,加上 MCDA 胎儿有 98 例;CVS 后有 98 例,对照组有 1124 例;羊膜穿刺后有 160 例,对照组有 1122 例。两种操作的 DCDA(CVS RR 5.54 95%CI 3.38-9.08,羊膜穿刺术 RR 2.36 95%CI 1.22-4.56)和 MCDA 双胎(CVS RR 5.14 95%CI 2.51-10.54,羊膜穿刺术 RR 7.01 95%CI 3.86-12.74)的 24+ 周前胎儿丢失率更高。正常胎儿丢失与对照组相比无差异(DCDA CVS RR 0.39 95%CI 0.05-2.83,DCDA 羊膜穿刺术 RR 1.16 95%CI 0.42-3.22,MCDA CVS RR 2.3 95%CI 0.71-7.56,MCDA 羊膜穿刺术 RR 1.93 95%CI 0.59-6.38)。

结论

本研究表明,DCDA 和 MCDA 双胎在 CVS 和羊膜穿刺术后胎儿丢失率增加,对正常胎儿的风险不确定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e52e/9828484/d688c67fc2d3/PD-42-1554-g001.jpg

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