Diagnostic fetal blood sampling-technique related losses.
Diagnostic fetal blood sampling-technique related losses.
复制标题
诊断胎儿血液采样技术相关的损失。
DOI：
10.1159/000264298
复制
发表时间：
1996
影响因子：
2.2
通讯作者：
Okamura,K
中科院分区：
文献类型：
--
作者：
Weiner,CP;Okamura,K
背景：脐带穿刺术的应用受其安全性的限制。脐带穿刺可徒手或借助固定导针进行。最近的报告显示，徒手作画的失失率为1-7%。该技术对围产期流产率的潜在影响尚未得到检验。研究设计：两个胎儿诊断和治疗单位，一个在美国（10名操作人员），一个在日本（15名操作人员），在固定针导的帮助下进行诊断性脐窝穿刺，从前瞻性维护的数据库中计算出与手术相关的损失率，并与使用徒手技术的大型中心发表的经验进行比较。结果：共进行1260例诊断性cordocentso检查。取样时平均妊娠期为29.1±5周。脐静脉90%穿刺。有12例手术相关的损失，总围产期损失率为0.9%。漏失风险与作业者先前操作的次数之间没有关系。损失通常与脐动脉穿刺相关（41.7% vs. 9.2%, p = 0.002）。12例损失中有11例与术后心动过缓有关。8名死亡的胎儿患有三体或三倍体，1名患有肾脏发育不全，2名患有严重的早发性生长限制，1名患有恒河河病。对于除染色体异常和严重胎儿生长受限外的所有诊断，诊断性脐带穿刺的手术相关损失率为0.2%（2/ 1021）。结论：本研究提示技术是影响脐带穿刺损失率的一个变量。
Background: The applications of cordocentesis are limited by its safety. Cordocentesis is performed either freehand or with the aid of a fixed needle guide. Recent reports suggest a loss rate of 1–7% using the freehand technique. The potential influence of technique on the perinatal loss rate has not been examined. Study Design: The procedure-related loss rates of two fetal diagnosis and treatment units, one in the United States (10 operators) and one in Japan (15 operators), who perform diagnostic cordocentesis with the aid of a fixed needle guide is calculated from a prospectively maintained database and compared to the published experience of large centers who use a freehand technique. Results: A total of 1,260 diagnostic cordocenteses were performed. The mean gestation at sampling was 29.1 ± 5 weeks. The umbilical vein was punctured in 90%. There were 12 procedure-related losses yielding an overall perinatal loss rate of 0.9%. There was no relationship between the risk of a loss and the number of prior procedures the operator had performed. Losses were more often associated with puncture of the umbilical artery (41.7 vs. 9.2%, p = 0.002). Eleven of 12 losses were associated with a postprocedure bradycardia. Eight fetuses who died had either a trisomy or triploidy, 1 had renal agenesis, 2 had severe early-onset growth restriction and 1 had rhesus disease. For all diagnoses other than a chromosome abnormality and severe fetal growth restriction, the procedure-related loss rate from diagnostic cordocentesis was 0.2% (2/1,021). Conclusion: This study suggests that technique is a variable in the loss rate for cordocentesis.