Hibbard J U, Loy G L, Hibbard M C
Department of Obstetrics and Gynecology, University of Chicago, Illinois 60637.
Prenat Diagn. 1994 Dec;14(12):1107-12. doi: 10.1002/pd.1970141203.
A possible association of limb reduction defects with chorionic villus sampling (CVS) may be related to compromised umbilical blood flow from the trauma of the procedure. We hypothesized that because CVS may disrupt or compromise umbilical blood flow to the fetus, either by vasoconstriction, bradycardia, or emboli, we would detect these changes using Doppler velocimetry. A cohort of 21 consecutive consenting patients undergoing first-trimester elective CVS for prenatal diagnosis were entered into a prospective longitudinal study. Colour flow Doppler velocimetry was performed on fetal umbilical arterial blood flow immediately before and after CVS to measure the pulsatility index, fetal heart rate, per cent flow time, and maximum flow velocity. Measurements were obtained from three consecutive cardiac cycles in three different umbilical segments and averaged. Potentially confounding variables also recorded included gestational age, method of CVS, number of passes, number of aspirations, placental location, tissue sample size, and operator. Umbilical velocimetry values before and after CVS were compared using the paired t-test and showed no statistically significant differences. No differences were found when data were analysed by gestational age, sample size, method, number of aspirations, placental location, or operator. We were unable to detect any significant change in fetal umbilical arterial blood flow velocimetry or heart rate after performing CVS. Umbilical blood flow does not appear to be routinely compromised by CVS.
肢体减少缺陷与绒毛取样（CVS）之间可能存在的关联，可能与该操作创伤导致的脐血流受损有关。我们推测，由于CVS可能通过血管收缩、心动过缓或栓子破坏或损害胎儿的脐血流，我们可以使用多普勒测速法检测到这些变化。对21名连续同意接受孕早期选择性CVS进行产前诊断的患者进行了一项前瞻性纵向研究。在CVS前后立即对胎儿脐动脉血流进行彩色多普勒测速，以测量搏动指数、胎儿心率、血流时间百分比和最大流速。从三个不同脐段的三个连续心动周期获取测量值并取平均值。还记录的可能混淆变量包括孕周、CVS方法、穿刺次数、抽吸次数、胎盘位置、组织样本大小和操作人员。使用配对t检验比较CVS前后的脐测速值，未显示出统计学上的显著差异。按孕周、样本大小、方法、抽吸次数、胎盘位置或操作人员分析数据时，未发现差异。进行CVS后，我们无法检测到胎儿脐动脉血流测速或心率有任何显著变化。脐血流似乎不会因CVS而经常受到损害。
