【摘要】：目的 :比較孕中期血清學篩查和產(chǎn)前診斷在預防高齡孕婦唐氏綜合征等出生缺陷中的臨床應用價值。方法 :選取2011~2013年間在南京醫(yī)科大學附屬無錫婦幼保健院行羊水穿刺產(chǎn)前診斷的506例孕中期單胎妊娠高齡孕婦為研究對象,分為兩組:一組孕婦在診斷前知情同意后自愿進行了孕中期游離絨毛膜促性腺激素、游離雌三醇、甲胎蛋白等血清學指標檢測,篩查均為高風險(篩查高風險組,136例,神經(jīng)管缺陷高風險未計入內);另一組孕婦為≥35歲未行血清學篩查而直接行羊水穿刺產(chǎn)前診斷者(單純高齡組,370例)。根據(jù)兩組診斷結果及隨訪妊娠結局比較血清學篩查的臨床應用價值。結果:506例高齡孕婦中,共診斷染色體異常25例,陽性率4.94%。篩查高風險組共確診唐氏綜合征9例(6.60%),其他染色體異常4例(3.0%);隨訪發(fā)現(xiàn)該組不良妊娠結局發(fā)生率4.41%(6/136)。單純高齡組中檢出唐氏綜合征2例(0.50%),其他染色體異常10例(2.70%),不良妊娠結局發(fā)生率0.54%(2/367)。篩查高風險組對唐氏綜合征的檢出率和不良妊娠結局發(fā)生率均明顯高于單純高齡組(P0.01)。結論 :孕中期血清學篩查,不僅在高齡孕婦唐氏綜合征的預防中有較高應用價值,對評估高齡孕婦發(fā)生不良妊娠結局的風險也有較好作用。
[Abstract]:Objective: to compare the clinical value of serological screening and antenatal diagnosis in the prevention of birth defects such as Down's syndrome in elderly pregnant women. Methods: 506 elderly pregnant women with single pregnancy in the middle trimester of pregnancy were selected from 2011 to 2013 in Wuxi Maternal and Child Health Hospital affiliated to Nanjing Medical University as subjects. They were divided into two groups: one group of pregnant women voluntarily detected free chorionic gonadotropin, free estriol, alpha-fetoprotein and other serological indexes in the second trimester of pregnancy after informed consent before diagnosis, and all of them were at high risk (high risk group, 136 cases). The high risk of neural tube defects is not included. Another group of pregnant women 鈮，

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