PROCEDURE-RELATED FETAL LOSSES IN TRANSPLACENTAL VERSUS NONTRANSPLACENTAL GENETIC AMNIOCENTESIS

被引:27
作者
BOMBARD, AT [1 ]
POWERS, JF [1 ]
CARTER, S [1 ]
SCHWARTZ, A [1 ]
NITOWSKY, HM [1 ]
机构
[1] MONTEFIORE MED CTR,ALBERT EINSTEIN COLL MED,DEPT OBSTET & GYNECOL,DIV REPROD GENET,BRONX,NY 10467
关键词
GENETIC AMNIOCENTESIS; PLACENTA; PRENATAL DIAGNOSIS;
D O I
10.1016/0002-9378(95)90013-6
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: We hypothesize that loss rates after amniocentesis do not differ in transplacental and nontransplacental taps performed by experienced operators. STUDY DESIGN: Subjects were 1000 women undergoing second-trimester amniocentesis: 745 were referred for maternal age; 132 for positive maternal serum alpha-fetoprotein screens, 41 indicating a risk for fetal neural tube defect, 91 indicating a risk for fetal chromosome abnormality; and 123 were referred for other reasons. All procedures were videotaped. The placenta was anterior in 518 cases; in 306 of these the needle went through the placenta. All pregnancies were prospectively evaluated through delivery. RESULTS: There were 13 losses among the 1000 procedures (1.3%). The transplacental losses occurred from 4 to 71 days after procedure, median 26.5 days; the nontransplacental losses from 12 days after procedure to term, median 25 days. The loss rate was essentially similar in the two categories: six transplacental (1.96%) and seven nontransplacental (1%) (relative risk 1.52 [95% confidence limits 0.84 to 2.75], p = 0.23). If the three patients with elevated maternal serum cu-fetoprotein values were excluded from data analysis, the loss rates in the two groups were virtually identical (relative risk 0.98 [95% confidence limits 0.38 to 2.54], p = 1.0000). CONCLUSION: Transplacental amniocentesis does not appear to increase the fetal loss rate in the hands of experienced surgeons. Moreover, in view of the time span between amniocentesis and loss in both groups, a procedural cause seems questionable.
引用
收藏
页码:868 / 872
页数:5
相关论文
共 12 条
[1]  
[Anonymous], 1978, Br J Obstet Gynaecol, V85 Suppl 2, P1
[2]   GENETIC AMNIOCENTESIS - IMPACT OF PLACENTAL POSITION UPON THE RISK OF PREGNANCY LOSS [J].
CRANE, JP ;
KOPTA, MM .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1984, 150 (07) :813-816
[3]  
ELIAS S, 1992, GENETIC DISORDERS FE, P33
[4]  
Harlap S, 1980, HUMAN EMBRYONIC FETA, P145
[5]   MATERNAL AGE-SPECIFIC RATES OF NUMERICAL CHROMOSOME-ABNORMALITIES WITH SPECIAL REFERENCE TO TRISOMY [J].
HASSOLD, T ;
CHIU, D .
HUMAN GENETICS, 1985, 70 (01) :11-17
[6]   PREDICTIVE VALUES, RELATIVE RISKS, AND OVERALL BENEFITS OF HIGH AND LOW MATERNAL SERUM ALPHA-FETOPROTEIN SCREENING IN SINGLETON PREGNANCIES - NEW EPIDEMIOLOGIC DATA [J].
MILUNSKY, A ;
JICK, SS ;
BRUELL, CL ;
MACLAUGHLIN, DS ;
TSUNG, YK ;
JICK, H ;
ROTHMAN, KJ ;
WILLETT, W .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1989, 161 (02) :291-297
[7]  
PHILLIPS OP, 1992, OBSTET GYNECOL, V80, P353
[8]   REPRODUCTIVE OUTCOME FOLLOWING AMNIOCENTESIS FOR GENETIC INDICATIONS [J].
PORRECO, RP ;
YOUNG, PE ;
RESNIK, R ;
COUSINS, L ;
JONES, OW ;
RICHARDS, T ;
KERNAHAN, C ;
MATSON, M .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1982, 143 (06) :653-660
[9]  
SIMPSON NE, 1976, CAN MED ASSOC J, V15, P739
[10]  
STEIN Z, 1980, HUMAN EMBRYONIC FETA, P107