羊膜穿刺週數有限制嗎？羊膜穿刺注意事項、費用統整！

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class="container px-6 md:px-12 lg:px-8 mx-auto w-full lg:grid grid-cols-4"><div class="col-span-3 container mx-auto p-4 lg:p-6 mb-8 lg:mb-16 bg-white rounded-lg"><div class="text-green-200 font-bold text-xs md:text-sm overflow-hidden mb-3 md:mb-2 lg:mb-8"><a href="/tags/down's-syndrome-screening">．唐氏症篩檢</a><a href="/tags/prenatal-check">．產檢</a></div><h1 class="text-2xl lg:text-4xl font-bold text-gray-500 mb-2 lg:mb-3">羊膜穿刺週數有限制嗎？羊膜穿刺注意事項、費用統整！</h1><div class="text-xs md:text-sm text-gray-500 mb-6 md:mb-8 lg:mb-10"><span>刊出日期 : 2021-07-01</span><span class="ml-10">作者 : <a class="font-bold text-green-200" href="/about">李毅評生殖醫學中心主任</a></span></div><div class="container mx-auto markdown"><div data-gatsby-image-wrapper="" class="gatsby-image-wrapper gatsby-image-wrapper-constrained rounded-md"><div style="max-width:1728px;display:block"><img alt="" role="presentation" aria-hidden="true" src="data:image/svg+xml;charset=utf-8,%3Csvg%20height='1476'%20width='1728'%20xmlns='http://www.w3.org/2000/svg'%20version='1.1'%3E%3C/svg%3E" style="max-width:100%;display:block;position:static"/></div><img aria-hidden="true" data-placeholder-image="" style="opacity:1;transition:opacity 500ms linear" decoding="async" src="data:image/jpeg;base64,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" alt=""/><picture><source type="image/webp" srcset="https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=256&amp;h=219&amp;q=100&amp;fm=webp 256w,https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=513&amp;h=438&amp;q=100&amp;fm=webp 513w,https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=1025&amp;h=876&amp;q=100&amp;fm=webp 1025w" sizes="(min-width: 1025px) 1025px, 100vw"/><img data-gatsby-image-ssr="" data-main-image="" style="opacity:0" sizes="(min-width: 1025px) 1025px, 100vw" decoding="async" loading="eager" src="https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=1025&amp;h=876&amp;fl=progressive&amp;q=100&amp;fm=jpg" srcset="https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=256&amp;h=219&amp;fl=progressive&amp;q=100&amp;fm=jpg 256w,https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=513&amp;h=438&amp;fl=progressive&amp;q=100&amp;fm=jpg 513w,https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=1025&amp;h=876&amp;fl=progressive&amp;q=100&amp;fm=jpg 1025w" alt="羊膜穿刺好可怕？醫師建議：這五種人還是考慮羊膜穿刺吧！"/></picture><noscript><picture><source type="image/webp" srcset="https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=256&amp;h=219&amp;q=100&amp;fm=webp 256w,https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=513&amp;h=438&amp;q=100&amp;fm=webp 513w,https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=1025&amp;h=876&amp;q=100&amp;fm=webp 1025w" sizes="(min-width: 1025px) 1025px, 100vw"/><img data-gatsby-image-ssr="" data-main-image="" style="opacity:0" sizes="(min-width: 1025px) 1025px, 100vw" decoding="async" loading="eager" src="https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=1025&amp;h=876&amp;fl=progressive&amp;q=100&amp;fm=jpg" srcset="https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=256&amp;h=219&amp;fl=progressive&amp;q=100&amp;fm=jpg 256w,https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=513&amp;h=438&amp;fl=progressive&amp;q=100&amp;fm=jpg 513w,https://images.ctfassets.net/i2o3e6knau3c/2IoKI1bqM6NuPHRWuznlVl/d9f7653ba58eb464a3679464addefbab/1218-04.jpg?w=1025&amp;h=876&amp;fl=progressive&amp;q=100&amp;fm=jpg 1025w" alt="羊膜穿刺好可怕？醫師建議：這五種人還是考慮羊膜穿刺吧！"/></picture></noscript></div><section><p>羊膜穿刺痛嗎？羊膜穿刺危險嗎？大家都想了解羊膜穿刺注意事項，尤其是高齡產婦，從羊膜穿刺幾週要做、羊膜穿刺異常幾天通知，到羊膜穿刺nipt哪裡不同？一起看羊穿週數、羊膜穿刺過程、羊膜穿刺費用2021吧！</p></section><details class="pl-8 my-12" open=""><summary>目錄</summary><ul class="content"><li>一、聽說羊膜穿刺很可怕？你認識羊膜穿刺嗎？</li><li>二、羊膜穿刺報告</li><li>三、羊膜穿刺注意事項</li><li>四、羊膜穿刺費用2021</li></ul></details></div><div class="markdown"><div><h2 class=" block">一、聽說羊膜穿刺很可怕？你認識羊膜穿刺嗎？</h2><p>千辛萬苦終於懷孕了，馬上就必須面臨<a href="https://haveababy.tw/posts/pregnancy-22">產檢</a>的選擇題－唐氏症篩檢怎麼選？大家都知道唐氏症篩檢有多種不同的方法，包含第一孕期唐氏症篩檢、第二孕期唐氏症篩檢、nipt、羊膜穿刺，今天就為大家從「羊膜穿刺」介紹起。</p> <h3>(一)什麼是羊膜穿刺</h3> <p>羊膜穿刺英文為Amniocentesis，簡稱為羊穿。</p> <p>大部分的產婦來做羊膜穿刺，是為了檢測唐氏症，而羊膜穿刺與nipt，還有其他唐氏症篩檢不同之處是，<strong>羊膜穿刺是確診工具</strong> ，對於染色體三倍體疾患的診斷準確率接近100%，也被<strong>國際上視為產前診斷唐氏症的黃金準則 (Gold standard)。</strong></p> <p>羊膜穿刺過程</p> <p>羊膜穿刺過程中，醫師會藉由超音波的引導，將一根細細長長的針穿過孕婦肚皮、子宮壁，最後到達羊水腔，抽取約20c.c的羊水，來分析羊水細胞中，胎兒染色體的狀態，<strong>由於抽取的羊水量很少，不需要過度擔心。</strong></p> <p>羊膜穿刺檢查項目</p> <p>在羊膜穿刺檢查項目中，唐氏症是很重要的一部分，除了唐氏症之外，其他的染色體異常、基因體缺失、單一基因疾病等狀況，也能透過羊膜穿刺來確診，例如：血友病、海洋性貧血、狄喬治式症等等。</p> <h3>(二)誰需要羊膜穿刺</h3> <p><strong>雖然羊膜穿刺是唐氏症篩檢的確診工具，但其實並不是每個人都需要</strong>，以下告訴你羊膜穿刺幾歲的孕婦要做、什麼樣的狀況要做。</p> <p>通常以下這幾種狀況的孕婦會考慮進行羊膜穿刺：</p> <li>年滿34歲以上</li> <li>第一孕期唐氏症篩檢結果為高風險</li> <li>有家族遺傳疾病</li> <li>曾生育先天異常胎兒</li> <li>超音波檢查發現胎兒異常</li> <p><strong>通常符合以上條件者，也符合國健署羊膜穿刺補助資格。</strong></p> <h3>(三)羊膜穿刺週數</h3> <p>羊膜穿刺幾週做比較合適呢？這也是一個十分重要的問題。</p> 最建議的羊膜穿刺時間，一般是在16～18週之間。 <p><strong>羊穿週數不建議太早的原因</strong>：懷孕初期羊水量較少，抽取會有困難，細胞數也可能不足以完成染色體分析。</p> <p><strong>羊穿週數不建議太晚的原因</strong>：若羊膜穿刺報告出爐，有問題且需要終止妊娠，此時因為週數較大，所面臨的風險及傷害也會比較大。</p> </ul></div><div><h2 class=" block">二、羊膜穿刺報告</h2><p>接下來關於羊膜穿刺報告多久會出來、羊膜穿刺異常幾天通知等等問題，也一次為大家解答。</p> <p>羊膜穿刺報告的產出並沒有那麼簡單，必須歷經培養、分裂、染色、觀察等過程，因此會花費較長的時間，<strong>大約需要二到三週的時間。</strong></p> <p>通常羊膜穿刺結果正常的話，會直接在例行產檢時看報告。另外，羊膜穿刺異常通知的部分，<strong>如果你的羊膜穿刺染色體異常，會額外通知，請你提早回診看報告，</strong>　並討論後續處置，至於確切天數，則依各家醫療院所的流程而定。</p></div><div><h2 class=" block">三、羊膜穿刺注意事項</h2><p>不管大家是因為什麼原因必須進行羊膜穿刺，相信心情都是同樣的緊張，常遇見高齡產婦羊膜穿刺前，總是緊張的問我好多注意事項，更常遇見千辛萬苦才懷孕的不孕症患者，擔心得連覺都睡不著，身為一位醫師，我的責任當然也包含：告訴你羊膜穿刺風險、告訴你羊膜穿刺後注意事項，就聽我娓娓道來吧！</p> <h3>(一)羊膜穿刺風險</h3> <p>羊膜穿刺風險：羊膜穿刺雖然是非常安全的檢查，但無法保證完全沒有併發症，以下列出幾個羊膜穿刺風險供大家參考。</p> <li><strong>羊膜穿刺流產：</strong> 做羊膜穿刺流產的發生率約為千分之三。</li> <li><strong>羊膜穿刺後胎兒損傷：</strong> 由於羊膜穿刺是在超音波的引導下，看準位置進行，因此發生率極低，不到千分之一。</li> <li><strong>感染：</strong> 感染的問題並不常見，一般認為發生率小於千分之一。</li> <p>其餘的風險如羊膜穿刺破水、是較少發生的狀況，以下也列出羊膜穿刺注意事項供大家參考。</p> <h3>(二)羊膜穿刺注意事項</h3> <li><strong>羊膜穿刺前注意事項：</strong></li> <li>正常作息即可，<strong>不需要空腹。</strong></li> <li>建議羊膜穿刺當天有家屬陪同。</li> <li><strong>羊膜穿刺前一天停止塗抹乳液或妊娠油類產品在肚子上。</strong></li> <li><strong>羊膜穿刺後注意事項：</strong></li> <li>如醫療院所有提供羊膜穿刺後護理注意事項，請依照指示。</li> <li>做完羊膜穿刺休息至少半小時，返家後建議不要太勞累，還是多休息。</li> <li>羊膜穿刺扎針處可能會有像抽血的皮肉痛，為正常現象。</li> <li>非常少數的人會出現少量陰道出血、分泌物增加的現象，多休息即可改善。</li> <li>羊膜穿刺後出現<strong>大量出血、破水、腹痛、發燒等狀況，請盡速就醫。</strong></li> </ul></div><div><h2 class=" block">四、羊膜穿刺費用2021</h2><h3>(一)羊膜穿刺費用2021</h3> <p>以下為沒有接受補助的<strong>原始羊膜穿刺費用</strong></p> <li><strong>單胞胎：</strong> 羊膜穿刺費用各個醫療院所不一，大約落在8,000~10,000。</li> <li><strong>多胞胎：</strong> 同卵雙胞胎，穿刺一針，費用與單胞胎一樣，如為異卵雙胞胎，則需要穿刺兩針，價錢則以針數類推。</li> <h3>(二)羊膜穿刺補助</h3> <p>相信不少人都知道，國健署對於高齡產婦羊膜穿刺是有補助的，還有哪些條件符合羊膜穿刺費用補助的規範呢？</p> <li>年滿34歲以上產婦（高齡產婦）。</li> <li>第一孕期期唐氏症篩檢結果為高風險。</li> <li>有家族遺傳疾病。</li> <li>曾生育先天異常胎兒。</li> <li>超音波檢查發現胎兒異常。</li> 有更多相關問題想詢問李毅評醫師嗎？歡迎點擊下方按鈕開始諮詢，李醫師將盡快為您解答！ </code></pre></div><div><h2 class=" hidden">李毅評介紹</h2><blockquote> <p>威廉氏後人－李毅評醫師</p> <li>新光醫院生殖醫學中心主任</li> <li>教育部部定講師</li> <li>新光醫院婦產科獲頒最佳教學、服務優良獎主治醫師</li> <li>臺大醫學系跳級畢業，書卷獎得主</li> <li>以鍵盤婦產科筆名橫掃各大母嬰論壇、PTT、專欄流量達20萬</li> <li>婦產科知名作家，屢番受邀演講、直播、醫療活動</li>