超声引导下脐静脉穿刺术在先天畸形胎儿产前诊断中的应用

目的:探讨超声引导下脐静脉穿刺术在先天畸形胎儿产前诊断中的应用价值及安全性。方法:产前检查中B超提示胎儿畸形的孕妇27例,进行超声引导下脐静脉穿刺术,对所抽取的脐静脉血进行核型分析。结果:超声引导下脐静脉穿刺术穿刺成功率为96.3%(26/27),1例穿刺失败,在26例成功病例中一次性穿刺成功率为80.8%(21/26)。27例穿刺术中发生一过性并发症1例,为脐血管穿刺点渗漏;所有患者均未发生流产、早产、胎死宫内、宫内感染等严重并发症。26例终止妊娠,病理检查20例为单发畸形,6例为多发畸形,1例足月分娩一侧腋下畸胎瘤患儿,术后患儿恢复良好。染色体核型分析成功24例,其中6例为染色体异常,阳性率为25%。结论:超声引导下脐静脉穿刺术操作简单、成功率高、安全性高,在先天畸形胎儿产前诊断中有较高的应用价值。

Clinical Application of Ultrasound-guided Percutaneous Umbilical Sampling for the Prenatal Diagnosis of Congenital Abnormality

Objective: To analyze clinical value of ultrasound-gnided percutaneous umbilical blood sampling for the prenatal diagnosis of congenital abnormality. Methods: The punctures were performed under the guidance of ultrasound for twenty-seven clinically suspected abnormal pregnant women. All samples of the umbilical blood were analyzed. Results: The total success rate of cordocentesis was 96.3% (26/27). The success rate at first attempt was 80.8% (21/26). There was no complication in these groups of women such as abortion, preterm delivery, intrauterine fetal death and chorioamnionitis, except one case with leakage of the blood from umbilical cord. All of these 27 fetuses were confirmed to have malformation after delivery. Out of 26 cases with termination of pregnancy, 20 cases were single malformation, 6 cases were multiple malformation. One case had a baby in term delivery with teratoma in oneside of oxter, and the baby recovered after operation. Fetal blood karyotyping was performed successfully in 24 cases with 6 abnormal karyotypes. Conclusion: Ulrstasound-guided percutaneous umbilical sampling is a convenient and safe method with high efficiency and value for the prenatal diagnosis of congenital abnormality.