Sikovanyecz J, Nyári T, Faragó M, Sallay E, Gellén J, Szabó J
Szent-Györgyi Albert Orvostudományi Egyetem, Szeged, Szülészeti és Nögyógyászati Klinika.
Orv Hetil. 1998 Aug 30;139(35):2059-64.
Invasive intrauterine diagnostic procedures may be followed by feto-maternal transfusion. The authors studied the feto-maternal transfusion after cordocentesis. 199 women underwent fetal umbilical cord blood sampling for fetal karyotyping in weeks 15-26. Maternal serum alpha-fetoprotein level was measured before and after the procedure. The data were statistically analysed by multiple regression analysis and the paired and unpaired Student's t-tests. Twenty percent of more maternal serum alpha-fetoprotein level increase was observed in 73 (36.7%) women. Maximum feto-maternal transfusion was 0.684 ml. The average feto-maternal transfusion was 0.045 ml. No fetal exsanguination was observed. Positive correlation was found between bleeding time after cordocentesis (p = 0.0171) and feto-maternal transfusion as well as the duration of the procedure (p = 0.0275) and feto-maternal transfusion. Negative correlation was found between the amount of fetal blood sample and feto-maternal transfusion (p = 0.0431). The puncture site also influenced feto-maternal transfusion. If the cordocentesis has been performed at the insertion of the cord the feto-maternal transfusion was less than at the free floating umbilical cord (p = 0.0293). Higher feto-maternal transfusion was seen more often after transplacental cordocentesis (p = 0.002). These data suggest that fetomaternal transfusion in the indicator of the difficulty of the procedure.
侵入性宫内诊断操作后可能会发生胎儿 - 母体输血。作者研究了脐带穿刺术后的胎儿 - 母体输血情况。199名妇女在孕15 - 26周接受了胎儿脐带血采样以进行胎儿核型分析。在操作前后测量母体血清甲胎蛋白水平。数据通过多元回归分析以及配对和非配对学生t检验进行统计学分析。73名(36.7%)妇女观察到母体血清甲胎蛋白水平升高20%或更多。最大胎儿 - 母体输血为0.684毫升。平均胎儿 - 母体输血为0.045毫升。未观察到胎儿失血。发现脐带穿刺术后出血时间(p = 0.0171)与胎儿 - 母体输血之间以及操作持续时间(p = 0.0275)与胎儿 - 母体输血之间呈正相关。发现采集的胎儿血样量与胎儿 - 母体输血之间呈负相关(p = 0.0431)。穿刺部位也影响胎儿 - 母体输血。如果在脐带插入处进行脐带穿刺,胎儿 - 母体输血少于在游离脐带处(p = 0.0293)。经胎盘脐带穿刺后更常出现较高的胎儿 - 母体输血(p = 0.002)。这些数据表明胎儿 - 母体输血是操作难度的指标。