Проспективне обсерваційне дослідження застосування ультратонкої голки для амніоцентезу: первинні результати

Abstract

The article presents the experience and initial results of use of the puncture needle of small diameter with karandashami type of sharpening for amniocentesis in the ІІ trimester of pregnancy. The objective: to determine the effectiveness and safety of use ultrafine needle diameter 29G for amniocentesis in the ІІ trimester of pregnancy. Patients and methods. There was performed a prospective observational study of 80 cases of singleton 3 cases of multiple pregnancies in which amniocentesis was performed in the period from August 2013 to August 2016 at the bases of the Department of obstetrics, gynecology and fetal medicine NMAPE named after P. L. Shupyk medical center «Uniclinic». The study group included women aged from 21 to 42 years in the term of pregnancy from 16 to 20 weeks. Exclusion criteria were: the presence of vaginal bleeding less than two days before the procedure, body mass index above 35, receiving the preparations containing heparin, or aspirin for 12 hours before the procedure. All patients received informed consent for the procedure. In addition, each patient before amniocentesis filled a specially designed questionnaire, in which using a numeric rating (1 to 10) was ability to check criteria of general perception of the procedure, in particular the level of excitement about the potential complications and confidence in the correctness of the choice. Group comparison of the perception of the procedure were 100 patients who completed identical questionnaires before the procedure of the amniocentesis needle with a diameter of 20G, which are conducted at clinical sites in the period 2011-2013. Results. All volumes of amniotic fluid contained a sufficient number of fetal cells to determine the karyotype. In 8 fetus were found pathological changes in the number of chromosomes. Women tolerated the procedure well. No cases of complaints are recorded. Patients noted that the information on noninvasive ultra-thin needle, which was provided during pre-consultation also significantly reduce anxiety before surgery. In one case, diagnosed bradycardia of the fetus, which lasted a few minutes and then spontaneously passed. Within 7 days not recorded any complications. Conclusion. Given technique is adequate and safe alternative to amniocentesis with the use of large diameter needles and allows not only to reduce trauma to the amniotic membranes but also to decrease the level of excitement in women before the procedure and to facilitate the adoption of decisions about invasive prenatal diagnostics. Key words: amniocentesis, atraumatic punction needle, safety of invasive prenatal diagnostic.