Perinatal outcome of chorionic villus sampling versus amniocentesis.

T T Hsieh, J D Lee, D M Kuo, L M Lo, C C Hsieh, T H Chiu, J D Liou, Y K Soong
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Abstract

This study assesses the relative risks of first trimester transcervical chorionic villus sampling (CVS) versus midtrimester amniocentesis performed between April 1986 and March 1988. The most common indication for prenatal diagnosis was advanced maternal age. We discovered 5.1% chromosomal aberrations in CVS compared to 1.0% in amniocentesis. Bleeding was the most frequent early complication, and only 1 case had major hemorrhage with subsequent spontaneous abortion. The fetal loss rate (gestational age less than 28 weeks) was 4.5% in CVS versus 1.2% in amniocentesis, which was not significantly different from the background fetal loss rate reported in normal pregnancies after an 8-week gestational age. Three cases of fetal loss after CVS were probably procedure-related; 1 case had spontaneous abortion and 2 cases had chorioamnionitis. Therefore, we considered that the causal relationship between CVS and the infection was highly probable. The clinical pregnancy outcome indicated that there were no differences in overall perinatal mortality, Apgar score, body weight, body length, gestational age at delivery, intrauterine growth retardation, placenta weight and placental disorders between the CVS group and the amniocentesis group. The pregnancies did not reveal any specific effects of the prenatal diagnostic procedure, but a long-term pediatric follow-up is needed.

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绒毛膜绒毛取样与羊膜穿刺术的围产儿结局。
本研究评估了1986年4月至1988年3月间妊娠早期经宫颈绒毛膜绒毛取样(CVS)与妊娠中期羊膜穿刺术的相对风险。产前诊断最常见的指征是高龄产妇。我们在CVS中发现了5.1%的染色体畸变,而在羊膜穿刺术中发现了1.0%。出血是最常见的早期并发症,仅有1例大出血并发自然流产。胎儿丢失率(胎龄小于28周)CVS组为4.5%,羊膜穿刺术组为1.2%,与8周后正常妊娠的胎儿丢失率无显著差异。3例CVS术后胎儿丢失可能与手术有关;自然流产1例,绒毛膜羊膜炎2例。因此,我们认为CVS与感染之间的因果关系是非常可能的。临床妊娠结局显示,CVS组与羊膜穿刺术组在围产儿总死亡率、Apgar评分、体重、体长、分娩胎龄、宫内生长迟缓、胎盘重量、胎盘紊乱等方面均无差异。妊娠未显示出产前诊断程序的任何具体影响,但需要长期的儿科随访。
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