妊娠中期前壁胎盘行羊膜腔穿刺术的安全性探讨

目的探讨妊娠中期胎盘附着子宫前壁行羊膜腔穿刺术的安全性。方法对2 785例有产前诊断指征的孕19~22＋6周孕妇行羊膜腔穿刺术并记录手术中和手术后的并发症。结果 2 785例患者均穿刺成功,成功率为100.00%。前壁胎盘者与非前壁胎盘者比较,平均手术时间、胎心减慢率、流产或胎心丢失率、宫内感染率、羊水细胞培养失败率差异均无统计学意义（P〉0.05）,但出血发生率、肉眼血性羊水率差异有统计学意义（P〈0.05）。结论只要掌握手术技巧,选择合适的穿刺部位,前壁胎盘行羊膜腔穿刺术是安全的。

The safety of amniocentesis on anterior placenta in mid trimester of pregnancy

Objective To investigate the safety of amniocentesis on anterior placenta in mid trimester of pregnancy.Methods Amniocentesis was carried on 2785 pregnant women with 19-22＋6 weeks who had prenatal diagnosis indication.The complications were observed during and after amniocentesis.Results Amniocentesis was successful in all pregnant women with the success rate of 100.00%.The differences of the average puncture time,the incidence of slowing down of fetal heart,abortion or loss of fetal heart and uterine infection,failure rate of amniotic fluid cell culture were not significant between anterior placenta group and non-anterior placenta group（P0.05）.However,the differences of incidence of bleeding and bloody amniotic fluid were significant between these two groups（P0.05）.Conclusion Amniocentesis is safe on anterior placenta based on suitable puncture site and careful manipulation.