Antsaklis A, Daskalakis G, Papantoniou N, Michalas S
First Department of Obstetrics and Gynaecology, Athens University Medical School, Alexandra Maternity Hospital, Greece.
Prenat Diagn. 1998 Sep;18(9):934-40. doi: 10.1002/(sici)1097-0223(199809)18:9<934::aid-pd428>3.0.co;2-d.
The aim of this study, was to determine the fetal loss rate after fetal blood sampling (FBS) in relation to the indication. In total, 1981 FBS procedures (1878 pregnancies) were included, of which 117 were performed for the detection of congenital infection (group 1), 1437 for the detection of haemoglobinopathy (group 2), 233 for prenatal diagnosis with normal ultrasound findings (group 3), 121 for rapid karyotyping in cases with abnormal sonographic findings (group 4) and 73 for severe growth retardation (group 5). All the procedures were performed with a free-hand technique under continuous ultrasound guidance. Pregnancy losses occurring within two weeks of FBS were considered procedure-related losses. 343 pregnancies were terminated. Of the remaining 1535 continuing pregnancies, 73 (4.8 per cent) were lost, of which 39 (2.5 per cent) were lost within two weeks of the procedure. The procedure-related losses were 3 in 103 (2.9 per cent), 17 in 1090 (1.6 per cent), 2 in 191 (1 per cent), 11 in 84 (13.1 per cent) and 6 in 67 (8.9 per cent) in groups 1, 2, 3, 4 and 5, respectively. The differences in procedural loss between the five groups were highly significant, suggesting that the method entails a much higher risk when the fetus is structurally abnormal, or severely growth retarded. Patients should therefore be counselled before the procedure accordingly.
本研究的目的是确定胎儿血液取样（FBS）后的胎儿丢失率与适应证之间的关系。总共纳入了1981例FBS操作（1878例妊娠），其中117例用于检测先天性感染（第1组），1437例用于检测血红蛋白病（第2组），233例用于超声检查结果正常时的产前诊断（第3组），121例用于超声检查结果异常时的快速核型分析（第4组），73例用于严重生长受限（第5组）。所有操作均在连续超声引导下采用徒手技术进行。FBS后两周内发生的妊娠丢失被视为与操作相关的丢失。343例妊娠终止。在其余1535例继续妊娠中，73例（4.8%）丢失，其中39例（2.5%）在操作后两周内丢失。第1、2、3、4和5组与操作相关的丢失分别为103例中的3例（2.9%）、1090例中的17例（1.6%）、191例中的2例（1%）、84例中的11例（13.1%）和67例中的6例（8.9%）。五组之间操作丢失的差异具有高度显著性，表明当胎儿结构异常或严重生长受限时，该方法的风险要高得多。因此，应在操作前对患者进行相应的咨询。
