【摘要】：目的 :比較孕中期血清學(xué)篩查和產(chǎn)前診斷在預(yù)防高齡孕婦唐氏綜合征等出生缺陷中的臨床應(yīng)用價(jià)值。方法 :選取2011~2013年間在南京醫(yī)科大學(xué)附屬無(wú)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(duì)象,分為兩組:一組孕婦在診斷前知情同意后自愿進(jìn)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(xué)指標(biāo)檢測(cè),篩查均為高風(fēng)險(xiǎn)(篩查高風(fēng)險(xiǎn)組,136例,神經(jīng)管缺陷高風(fēng)險(xiǎn)未計(jì)入內(nèi));另一組孕婦為≥35歲未行血清學(xué)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(jié)果及隨訪妊娠結(jié)局比較血清學(xué)篩查的臨床應(yīng)用價(jià)值。結(jié)果:506例高齡孕婦中,共診斷染色體異常25例,陽(yáng)性率4.94%。篩查高風(fēng)險(xiǎn)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(jié)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(jié)局發(fā)生率0.54%(2/367)。篩查高風(fēng)險(xiǎn)組對(duì)唐氏綜合征的檢出率和不良妊娠結(jié)局發(fā)生率均明顯高于單純高齡組(P0.01)。結(jié)論 :孕中期血清學(xué)篩查,不僅在高齡孕婦唐氏綜合征的預(yù)防中有較高應(yīng)用價(jià)值,對(duì)評(píng)估高齡孕婦發(fā)生不良妊娠結(jié)局的風(fēng)險(xiǎn)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，

本文編號(hào)：2510812