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双绒毛膜双羊膜囊双胎妊娠的羊膜腔穿刺术与胎儿丢失风险:一项病例对照研究

Amniocentesis and Risk of Fetal Loss in Dichorionic-Diamniotic Twin Pregnancy: A Case-Control Study.

作者信息

Roero Sofia, Ingala Agata, Arduino Silvana, Bossotti Carlotta, Bastonero Simona, Comoglio Francesca Maria, Dusini Ilaria, Pertusio Annasilvia, Scali Roberto, Sdei Simona, Revelli Alberto, Sciarrone Andrea

机构信息

Gynaecology and Obstetrics 2U, Sant'Anna Hospital, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.

Obstetrics and Gynecological Ultrasound and Prenatal Diagnosis Center, Sant'Anna Hospital, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.

出版信息

Prenat Diagn. 2025 Jun;45(6):713-719. doi: 10.1002/pd.6777. Epub 2025 Mar 18.

Abstract

OBJECTIVE

There is a paucity of data regarding the risk of fetal loss due to invasive prenatal diagnosis in twins. The aim of the present study is to assess the rate of amniocentesis-related fetal loss in uncomplicated dichorionic-diamniotic (DCDA) twin pregnancies.

METHODS

Retrospective observational case-control study. DCDA twin pregnancies undergoing amniocentesis between January 2010 and December 2023 formed the case group. The control group comprised counterparts who did not undergo amniocentesis. The primary outcome of the study was procedure-related fetal loss. Secondary outcomes were miscarriage rate, overall fetal loss and gestational age at birth.

RESULTS

Our dataset included 220 and 662 women in the case and control groups, respectively. No difference in the primary outcome was found: procedure-related fetal loss of one fetus was 0.9% in the case group and 1.1% in the control group, and of both fetuses it was 0.5% in both groups (p = 0.982). No difference was found in secondary outcomes: the fetal loss rate of one fetus was 1.8% in the case group and 2.1% in the control group, while that of both fetuses it was 0.5% and 0.8% respectively (p = 0.853). Multivariate analysis confirmed the nonsignificant effect of amniocentesis on the risk of fetal loss.

CONCLUSION

Amniocentesis does not seem to increase the risk of fetal loss in uncomplicated DCDA twin pregnancies above the baseline risk of loss among twin gestations.

摘要

目的

关于双胎妊娠侵入性产前诊断导致胎儿丢失风险的数据较少。本研究的目的是评估单纯双绒毛膜双羊膜囊(DCDA)双胎妊娠中羊水穿刺相关的胎儿丢失率。

方法

回顾性观察病例对照研究。2010年1月至2023年12月期间接受羊水穿刺的DCDA双胎妊娠构成病例组。对照组包括未接受羊水穿刺的对应孕妇。研究的主要结局是与操作相关的胎儿丢失。次要结局是流产率、总体胎儿丢失率和出生时的孕周。

结果

我们的数据集中病例组和对照组分别有220名和662名女性。主要结局未发现差异:病例组单胎与操作相关的胎儿丢失率为0.9%,对照组为1.1%;两组双胎的该丢失率均为0.5%(p = 0.982)。次要结局也未发现差异:病例组单胎胎儿丢失率为1.8%,对照组为2.1%;双胎的胎儿丢失率分别为0.5%和0.8%(p = 0.853)。多变量分析证实羊水穿刺对胎儿丢失风险无显著影响。

结论

在单纯DCDA双胎妊娠中,羊水穿刺似乎不会使胎儿丢失风险高于双胎妊娠的基线丢失风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86c8/12137027/db297a2756f6/PD-45-713-g001.jpg

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