Levine D, Callen P W, Pender S G, McArdle C R, Messina L, Shekhar A, Wong G P
Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Radiology. 1998 Oct;209(1):175-81. doi: 10.1148/radiology.209.1.9769829.
To determine the frequency and importance of chorioamniotic separation (CAS) after second-trimester genetic amniocentesis.
In part 1 of the study, ultrasonography (US) databases were reviewed for cases of CAS. In part 2, a study population of 388 women undergoing amniocentesis underwent directed US examination for assessment of CAS 15 minutes and/or 2 weeks after amniocentesis. CAS, when present, was graded. A control population consisted of 363 women undergoing amniocentesis in whom the membranes were not assessed.
In part 1, a review of 23,883 records revealed seven cases of complete CAS, with three deaths, two preterm deliveries, and one emergency cesarean section delivery due to fetal distress. In two of these cases, there were extremity deformities at birth. In part 2, CAS was present in 98 (25%) of 388 women at some point. There was no association between CAS and procedural variables. There was no substantial difference in morbidity between patients with and those without CAS, between patients with different grades of CAS, or between the study and control populations.
Small degrees of CAS are frequently present after amniocentesis but are not detected because the membranes are not specifically evaluated. Complete CAS is less frequent.
确定孕中期遗传羊膜腔穿刺术后绒毛膜羊膜分离（CAS）的发生率及重要性。
在研究的第1部分，回顾超声检查（US）数据库中CAS的病例。在第2部分，388例行羊膜腔穿刺术的女性研究人群在羊膜腔穿刺术后15分钟和/或2周接受针对性US检查以评估CAS。如有CAS存在，则进行分级。对照组由363例行羊膜腔穿刺术但未评估胎膜的女性组成。
在第1部分，对23883份记录的回顾发现7例完全性CAS，其中3例死亡，2例早产，1例因胎儿窘迫行急诊剖宫产。在其中2例中，出生时有肢体畸形。在第2部分，388名女性中有98名（25%）在某个时间点出现CAS。CAS与操作变量之间无关联。有CAS与无CAS的患者之间、不同等级CAS的患者之间以及研究人群与对照人群之间的发病率无实质性差异。
羊膜腔穿刺术后常出现小程度的CAS，但因未对胎膜进行专门评估而未被检测到。完全性CAS较少见。
