PDF(Pubmed)
Abstract：
BACKGROUND: Cordocentesis is used in clinical situations in which lower-risk diagnostic procedures do not deliver the desired results. The aim of this study was to evaluate the risk for procedure-related complications and fetal loss in correlation to maternal risk factors.
METHODS: This is a multicenter retrospective study investigating the complications, risk factors and perinatal outcome of diagnostic cordocentesis between 1998 and 2019 in three different centers.
RESULTS: A total of 1806 cordocenteses were performed and procedure-related complications (IUFD within 48 h, contractions, bradycardia, unsuccessful puncture, chorioamniotic separation) were noted in 1.6% of cases. Fetuses with chromosomal aberrations, intrauterine growth restriction and hydropic fetuses had a significantly higher rate of fetal loss compared to other indications. Fetal blood sampling (FBS) performed before 17+0 weeks of gestation was associated with a higher risk of procedure-related complications. Maternal BMI ≥ 40 increased the risk for fetal loss, whereas maternal age, number of previous miscarriages, number of previous abortions, history of vaginal bleeding or nicotine abuse did not affect the risk for complications or overall fetal loss rate.
CONCLUSIONS: In the hands of experienced operators, FBS is a safe way to further fetal diagnostics, and the risk of complications is low.
METHODS: This is a multicenter retrospective study investigating the complications, risk factors and perinatal outcome of diagnostic cordocentesis between 1998 and 2019 in three different centers.
RESULTS: A total of 1806 cordocenteses were performed and procedure-related complications (IUFD within 48 h, contractions, bradycardia, unsuccessful puncture, chorioamniotic separation) were noted in 1.6% of cases. Fetuses with chromosomal aberrations, intrauterine growth restriction and hydropic fetuses had a significantly higher rate of fetal loss compared to other indications. Fetal blood sampling (FBS) performed before 17+0 weeks of gestation was associated with a higher risk of procedure-related complications. Maternal BMI ≥ 40 increased the risk for fetal loss, whereas maternal age, number of previous miscarriages, number of previous abortions, history of vaginal bleeding or nicotine abuse did not affect the risk for complications or overall fetal loss rate.
CONCLUSIONS: In the hands of experienced operators, FBS is a safe way to further fetal diagnostics, and the risk of complications is low.
摘要：
背景：在低风险诊断程序无法提供所需结果的临床情况下，使用Cord穿刺术。这项研究的目的是评估与母体风险因素相关的手术相关并发症和胎儿丢失的风险。
方法：这是一项调查并发症的多中心回顾性研究，1998年至2019年三个不同中心诊断性脐带穿刺术的危险因素和围产期结局.
结果：共进行了1806例心脏手术，手术相关并发症（IUFD在48小时内，收缩，心动过缓,穿刺不成功,绒毛膜羊膜分离）在1.6％的病例中被注意到。胎儿染色体畸变,与其他适应症相比，宫内生长受限和积水胎儿的胎儿丢失率明显更高。在妊娠17+0周之前进行的胎儿采血（FBS）与手术相关并发症的高风险相关。母亲BMI≥40会增加胎儿丢失的风险，而母亲的年龄，以前流产的次数，以前堕胎的次数，阴道出血或尼古丁滥用史不影响并发症的风险或总体胎儿丢失率.
结论：在经验丰富的操作员手中，FBS是进一步诊断胎儿的安全方法,并发症的风险很低。
方法：这是一项调查并发症的多中心回顾性研究，1998年至2019年三个不同中心诊断性脐带穿刺术的危险因素和围产期结局.
结果：共进行了1806例心脏手术，手术相关并发症（IUFD在48小时内，收缩，心动过缓,穿刺不成功,绒毛膜羊膜分离）在1.6％的病例中被注意到。胎儿染色体畸变,与其他适应症相比，宫内生长受限和积水胎儿的胎儿丢失率明显更高。在妊娠17+0周之前进行的胎儿采血（FBS）与手术相关并发症的高风险相关。母亲BMI≥40会增加胎儿丢失的风险，而母亲的年龄，以前流产的次数，以前堕胎的次数，阴道出血或尼古丁滥用史不影响并发症的风险或总体胎儿丢失率.
结论：在经验丰富的操作员手中，FBS是进一步诊断胎儿的安全方法,并发症的风险很低。
