Sundberg K, Lundsteen C, Philip J
Department of Clinical Genetics, Juliane Marie Center, National University Hospital, Copenhagen, Denmark.
Prenat Diagn. 1996 Dec;16(12):1121-7. doi: 10.1002/(SICI)1097-0223(199612)16:12<1121::AID-PD6>3.0.CO;2-Z.
In 44 pregnancies where chorionic villus sampling (CVS) had shown mosaicism, early amniocentesis using a filter technique was carried out with the purpose of clarifying the fetal karyotype and reducing the waiting time for a final karyotype. Since the filter technique increases the cell yield of the amniotic fluid sample, it was hypothesized that this technique could be applied as soon as the mosaic CVS result was available, without compromising the culturing of the amniotic fluid cells. The mean gestational age at amniocentesis was 12.5 weeks and the mean gestational age at the time of the final karyotype was 13.9 weeks. All amniotic fluid sampling procedures and cultures were successful. Four pregnancies were terminated due to abnormal karyotypes (9.1 per cent). Two spontaneous abortions occurred in the second trimester (5.0 per cent), and one infant was lost at term due to unexplained intrapartum death. The total fetal loss rate was 7.5 per cent. This loss rate is concordant with other reported series where the outcome of pregnancies with placental mosaicism has been evaluated. We conclude that early amniocentesis with the filtration technique is a useful method for follow-up on CVS, mosaicism, providing results prior to 14 weeks of gestation.
在44例经绒毛取样(CVS)显示存在嵌合体的妊娠中,采用过滤技术进行了早期羊水穿刺,目的是明确胎儿核型并缩短等待最终核型结果的时间。由于过滤技术可提高羊水样本的细胞产量,因此推测该技术可在获得嵌合CVS结果后立即应用,而不会影响羊水细胞的培养。羊水穿刺时的平均孕周为12.5周,最终核型结果出来时的平均孕周为13.9周。所有羊水取样程序和培养均成功。4例妊娠因核型异常而终止(9.1%)。孕中期发生2例自然流产(5.0%),1例婴儿足月时因不明原因的产时死亡而丢失。总胎儿丢失率为7.5%。该丢失率与其他评估胎盘嵌合妊娠结局的报道系列一致。我们得出结论,采用过滤技术的早期羊水穿刺是对CVS嵌合体进行随访的一种有用方法,可在妊娠14周前提供结果。