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目的探讨超声引导脐静脉穿刺术在孕中晚期产前诊断中的安全性及应用价值。方法对875例孕周为18~33+4的孕中晚期孕妇因各种原因行超声引导脐静脉穿刺术,并对所抽取的脐静脉血进行核型分析。结果超声引导脐静脉穿刺成功率为99.5%;胎盘或脐带一过性渗血发生率22.5%;胎儿短暂心动过缓发生率4.0%;胎儿丢失发生率0.5%。染色体核型分析发现核型异常65例,异常率为7.4%,其中数目异常41例;结构异常24例。另发现重型地中海贫血8例,巨细胞病毒感染2例。异常诊断结果总检出率为8.6%。结论超声引导下脐静脉穿刺术具有很高的成功率和安全性,弥补了孕中晚期产前诊断方法的空缺,并能从多方面进行病因学诊断。
Objective To investigate the safety and application value of ultrasound-guided umbilical vein puncture in the diagnosis of prenatal pregnancy. Methods 875 pregnant women with gestational age of 18 ~ 33 + 4 received ultrasound-guided umbilical vein puncture for various reasons. The karyotypes of umbilical cord blood samples were analyzed. Results The success rate of ultrasound-guided umbilical vein puncture was 99.5%. The incidence of transient oozing of placenta or umbilical cord was 22.5%. The incidence of fetal transient bradycardia was 4.0%. The incidence of fetal loss was 0.5%. Karyotype analysis revealed 65 karyotype abnormalities with an abnormal rate of 7.4%, of which 41 were abnormal in number and 24 were structural abnormalities. Another found in 8 cases of thalassemia major, cytomegalovirus infection in 2 cases. The total detection rate of abnormal diagnosis was 8.6%. Conclusion Ultrasound-guided umbilical vein puncture has a high success rate and safety, which can make up for the vacancy of prenatal diagnosis in the second trimester of pregnancy and can diagnose etiology from many aspects.