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目的:探讨妊娠中期不同指征孕妇行羊膜腔穿刺的临床意义。方法:对2003年～2010年间在无锡市妇幼保健院产前接受羊膜腔穿刺术的3 790例孕妇的资料进行回顾性分析。结果:3 790例孕妇均一次穿刺成功,羊水培养成功率99.23%(3 761/3 790);唐氏综合征筛查高风险接受羊膜腔穿刺者占73.64%(2 791/3 790);染色体核型异常检出率4.85%(184/3790),夫妇双方之一染色体异常时子代染色体异常检出率最高,达22.58%(7/31),孕妇高龄羊膜腔穿刺者阳性率5.99%(27/451);中孕血清学筛查21-三体及18-三体高风险病例穿刺阳性诊断率为4.37%(122/2 791)、9.09%(8/88);因羊膜腔穿刺者结果异常终止妊娠率55.43%(102/184)。结论:妊娠中期羊膜腔穿刺是安全可靠的侵入性产前诊断方法,详细收集孕妇病史信息、结合超声检测结果明确产前诊断指征可提高异常染色体核型的检出率。
Objective: To investigate the clinical significance of amniocentesis in different indications of pregnant women in the second trimester of pregnancy. Methods: The data of 3 790 pregnant women undergoing amniocentesis prenatal at Wuxi Maternal and Child Health Hospital from 2003 to 2010 were retrospectively analyzed. Results: A total of 3 790 pregnant women were successfully punctured. The successful rate of amniotic fluid culture was 99.23% (3 761/3 790). Down syndrome was high risk of receiving amniocentesis accounted for 73.64% (2 791/3 790) The detection rate of karyotype abnormality was 4.85% (184/3790). The chromosomal abnormality rate of one of the two couples was the highest (22.58% (7/31)), and the positive rate of the aged amniocentesis was 5.99% 27/451). The positive diagnostic rates of 21- trisomy and 18- trisomy in the second trimester were 4.37% (122/2 791) and 9.09% (8/88), respectively. As a result of amniocentesis Abortion termination rate was 55.43% (102/184). Conclusion: Amniocentesis is a safe and reliable method of invasive prenatal diagnosis in the second trimester of pregnancy. Detailed information on the history of pregnant women is collected. Combined with the results of ultrasonography, the prenatal diagnosis can improve the detection rate of abnormal karyotype.