Analysis On The Indications And Results Of Amniocentesis In1153Cases

Background: Prenatal diagnosis refers to detection and diagnosis in terms of the embryo orfetus’s growth situation and whether it has congenital diseases or not and other conditionsbefore birth. As a high-risk and highly difficult technology, prenatal diagnosis is a prenataldiagnostic method for pregnant women at different gestational weeks. At present, most ofpregnant women receiving prenatal diagnosis are older pregnant women (age≥35years old)or pregnant women who have high risk of having a child with Down’s syndrome in maternalserum in prenatal screening. Recently, the collection and statistics of some foreign clinicaldata[1]have confirmed that the screening rate of prenatal screening in the first trimester andprenatal screening combined with color Doppler ultrasound of fetal organs and appearance inthe second trimester is significantly higher than that of prenatal screening in the first andsecond trimesters alone. Moreover, the current occurrence rate of aneuploid deformed fetusin prenatal screening in China is greater than90%and the false positive rate is no more than5%[2]. With resort to chorionic villus sampling in the first trimester, amniotic fluid samplingthrough amniocentesis in the second trimester and percutaneous umbilical cord venous bloodsampling in the third trimester, fetal karyotype analysis can be used as the “Gold Standard”for prenatal diagnosis. Now amniocentesis is the most common method for fetal karyotypeanalysis. The best sampling time of amniocentesis is at week16to21of pregnancy. Apuncture needle is used to run through the uterus via abdomen to penetrate the amnioticcavity, and then amniotic fluid is sampled for cell culture in vitro. Next, the fetal karyotypeis identified to analyze whether the number or structure of chromosomes is abnormal or not.Objective: By analyzing the indications and results of amniocentesis of1,153cases, westudied the correlation between the indications and results of amniocentesis and exploredthe rationality and validity of the indications of amniocentesis in our hospital in order toprovide further guidance for clinical practice. Methods:1153pregnant women undergoing amniocentesis in the prenatal diagnosis centerof our hospital from January2013to December2013were collected. The indications ofamniocentesis of all subjects were retrospectively analyzed. A database was set up byEXCEL software to analyze abnormal chromosome results. All pregnant women stoppedsexual activity for2weeks in advance and emptied their bladders10minutes beforeoperation.21G×200mm puncture needle was used to perform probe puncture guidegroove-guided amniocentesis with ultrasound localization. A50ml injector was used to take20ml-30ml of amniotic fluid before sending to laboratory for cell culture and karyotypeanalysis.Results:①With down syndrome screening high-risk pregnancy early for amniocentesisindications in2cases, no abnormal chromosome;②In down syndrome screening high～risk pregnancy for amniocentesis indications of590cases of chromosomal abnormalities for40cases, chromosome abnormality rate6.7%(40/590);③For down syndrome screeningcritical risk during pregnancy in the amniotic fluid puncture indications of226cases,8cases,the chromosome abnormality of chromosome abnormality rate3.5%(8/226);④With age asamniocentesis indications of281cases of chromosome abnormality for the16cases,chromosome abnormality rate5.6%(16/281);⑤Adverse reproductive history foramniocentesis indications26patients, the chromosome abnormality in2cases, chromosomeabnormality rate of7.6%(2/26);⑥with abnormal ultrasonic as an amniocentesis indications,24cases of chromosome anomaly in6cases, chromosome abnormality rate of30%(6/24);⑦With her husband chromosome balance ectopic carriers for amniocentesis indications in4cases, the chromosome abnormality in1case,25%proportion of chromosomalabnormalities (1/4);⑧In abnormal pregnant women I dyed for amniocentesis indications in2cases, no chromosome abnormality.Conclusions:1. As indications of amniocentesis, nuchal translucency (NT) abnormality inthe first trimester and high risk of Down’s screening in the second trimester are of greatclinical application values.2. For pregnant women with advanced age as an indication ofamniocentesis, the occurrence of chromosome abnormalities among pregnant women aged≥40is larger than that among pregnant women aged≥40. Therefore, aged≥40is a feasible indication of amniocentesis.3. Taking abnormal reproductive history as an indication ofamniocentesis is an effective way to lower the birth rate of fetal chromosomal abnormality.4.The occurrence of chromosomal abnormality shows a poor correlation with high risk ofDown’s screening in the first trimester and chromosomal abnormality of pregnant women asindications of amniocentesis.