摘要
目的分析孕中期进行血清学筛查对产前诊断以及妊娠结局预测的临床应用价值。方法选取2013年9月—2016年3月来我院进行孕中期血清学筛查的53 500例孕妇,所有患者均行AFP、free-β-HCG、μE3三联血清学检测,对筛查确定妊娠高风险者进行羊水穿刺产前诊断,对于开放性神经管缺陷(ONTD)行多普勒超声检测予以确诊。对患者的妊娠结局进行随访。结果 53 500例产前筛查孕妇中,共筛出高风险2 493例(4.66%),1 494例行介入性产前诊断者染色体结果异常共74例(4.95%),其中年龄在35岁以上染色体异常的阳性检出率为12.70%(32/252);年龄在35岁以下的染色体异常的阳性检出率为3.38%(42/1 242),二者对比差异具有统计学意义(P<0.05)。随访结果显示,高风险人群不良妊娠结局发生率为1.36%(34/2 493)高于低风险人群的0.14%(70/51 007)(P<0.05)。高风险人群中35岁以上孕妇出现不良妊娠结局的占3.61%(15/416),35岁以下出现不良妊娠结局的占0.91%(19/2 077),二者对比差异具有统计学意义(P<0.05)。结论孕中期血清学筛查可以筛查出胎儿染色体以及结构畸形,另外对不良妊娠结局也有一定的指导作用,尤其在对高龄产妇出现缺陷儿以及不良妊娠结局的预测效果更为显著。
Objective To analyze the clinical value of serological screening in the second trimester of pregnancy in prenatal diagnosis and prediction of pregnancy outcome.Methods 53 500 pregnant women were selected from September 2013 to March 2016,for serologic screening in our second trimester,all patients underwent AFP,free-β-HCG,μE3 triple serological detectionboth,prenatal diagnosis of amniocentesis was performed in screening for high-risk pregnancies,doppler ultrasonography was performed in the diagnosis of open neural tube defects（ONTD）.The outcome of the pregnancy was followed up.Results There was 2 493 cases（4.66%） screened out of high-risk in 53 500 cases of prenatal screening of pregnant women,there were 74 cases（4.95%） of chromosomal abnormalities in 1 494 cases of routine prenatal diagnosis,the positive of chromosomal abnormalitiy more than 35 years and above was 12.7%（32/252）,the positive rate of chromosome abnormality under the age of 35 and above was 3.38%（42/1 242）,the difference between two groups was statistically significant（P〈0.05）.The results of follow-up showed that the incidence of adverse pregnancy outcomes was 1.36%（34/2 493） in high-risk group,which was significantly higher than that in low risk group（70/51 007）（P〈0.05）.The incidence of adverse pregnancy outcomes was 3.61%（15/416） in high-risk population over the age of 35,and the incidence of adverse pregnancy outcomes below the age of 35 was 0.91%（19/2 077）,the difference between two groups was statistically significant（P〈0.05）.Conclusion Second trimester serological screening can screen out fetal chromosomes and structural malformations,and also have some guidance on the adverse pregnancy outcomes,especially in the elderly maternal defective child and adverse pregnancy outcome prediction is more significant.
作者
傅婉玉
FU Wanyu(Prenatal Diagnosis Center, Children＇s Hospital of Quanzhou maternal and ChiM Health Hospital, Quanzhou Fujian 362000, Chin)
出处
《中国卫生标准管理》
2017年第4期107-109,共3页
China Health Standard Management
关键词
孕中期血清学筛查
产前诊断
妊娠结局预测
serological screening in the second trimester of pregnancy
prenatal diagnosis
pregnancy outcome prediction
