双胎妊娠介入性产前诊断不同取样方法术后流产风险评估及相关因素分析  

Risk Assessment of Miscarriage of Twin Pregnancy after Different Invasive Prenatal Diagnosis Sampling

作　　者：赵馨[1] 黄演林[1] 何薇[1] 刘倩[1] 钟燕芳[1] 麦明琴[1] 朱娟[1] 熊盈[1] 吴菁[1] ZHAO Xin;HUANG Yanlin;HE Wei(Medical Genetic Center,Guangdong Women and Children Hospital,Guangzhou Guangdong 510010,China)

机构地区：[1]广东省妇幼保健院医学遗传中心,广东广州510010

出　　处：《实用妇产科杂志》2021年第3期217-220,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨介入性产前诊断不同取样方法应用于双胎妊娠的术后流产风险,并分析影响术后流产风险的相关因素。方法:回顾性分析2015年1月至2019年3月广东省妇幼保健院产前诊断中心行介入性产前诊断的452例双胎妊娠的临床资料。按照介入性产前诊断不同取样方法分为3组:绒毛取材组(33例)、羊膜腔穿刺组(376例)、脐血取样组(43例),分析孕妇的一般情况、介入性产前诊断的手术情况及妊娠结局,并分析术后2周流产率的差别,采用Logistics回归分析其与流产的相关因素。结果:绒毛取材组术后的流产率3.0%,羊膜腔穿刺组术后流产率2.4%,脐血取样组术后流产率2.3%,3组术后流产率差异无统计学意义(P>0.05)。单因素分析示,绒毛膜性、妊娠方式、孕妇年龄不同均不增加术后流产的风险(P>0.05)。Logistics回归分析模型校正孕妇年龄、妊娠方式和绒毛膜性质等多因素后,3种取样术并未显著增加胎儿流产的风险(P>0.05)。结论:双胎妊娠介入性产前诊断中不同取样方法可能并不增加术后的流产风险,临床上可根据实际情况选择合适的方式尽可能早期诊断。Objective:To assess the risk of fetal loss in twin pregnancy after different invasive prenatal diagnosis methods and to identify the impact of related characteristics on postoperative miscarriage.Methods:A retrospective study was performed on 452 twin-pregnant women who received invasive prenatal diagnosis from January 2015 to March 2019 at Prenatal Diagnosis Centre in Guangdong Women and Children Hospital.The pregnancy information was analyzed to assessthe miscarriage risk in twin-pregnant women with different invasive methods and to explore whether any maternal pregnancy characteristics had impacts on postoperative miscarriage.Results:There was no significant difference in the miscarriage risk caused by different invasive methods(Chorionic villus sampling 3.0%,Amniocentesis 2.4%,Cordocentesis 2.3%).The way of pregnancy, age of pregnant women, and the twin chronicity might not be the high-risk factors of postoperative miscarriage(P>0.05).After adjusting for confounding factors, multivariate logistic regression analysis revealed that no significant difference was found in the risk of fetal miscarriage after three different prenatal diagnostic sampling(P>0.05).Conclusions:Our results indicate that there is no significant difference inmiscarriage risk caused by different sampling methods.Clinical practitioners can choose the appropriate method as early as possible.

关 键 词：双胎妊娠 介入性产前诊断 羊膜腔穿刺术 绒毛取材术 脐血取样术 流产 

分 类 号：R714.5[医药卫生—妇产科学]