孕中期唐氏筛查假阳性在预测胎膜早破中的临床意义

Clinical value of false positive of Down's syndrome screening for premature rupture of membranes

目的探讨孕中期唐氏筛查假阳性在预测胎膜早破中的临床意义。方法我院2009年1月至2013年7月有321例妊娠中期唐氏筛查高风险孕妇,均行染色体检查排除染色体异常,孕期序列超声检查未见胎儿器官结构异常,电话或者门诊随访妊娠结局;同时随访346例低风险孕妇妊娠结局,孕期超声亦未发现器官结构异常。结果 321例孕妇唐氏筛查假阳性孕妇中,14例因胎膜早破流产(孕龄小于28周);17例因胎膜早破早产,其中孕28周至孕34周为9例,孕34周至孕37周为8例;新生儿窒息为7例。低风险组中,孕28周前因胎膜早破发生流产6例,3例孕28周至孕34周之间因胎膜早破发生流产,4例孕34周至孕37周发生胎膜早破,新生儿窒息为3例。结论唐氏筛查假阳性孕妇相对于低风险孕妇,更容易发生胎膜早破;唐氏筛查高风险可作为预测胎膜早破的一个潜在指标。

Objective To explore the clinical value of false positive of Down’ s Syndrome Screening for premature rupture of membranes in the second trimester of pregnancy. Methods From Jan. 2009 to Jul. 2013, there were 321 cases who were in the second trimester of high risk pregnancy recieved Down’ s Syndrome Screening. Their fetals have been excluded chromosome or organ abnormality, and there was no fetal organ structure abnormal through sequence prenatal ultrasound examinations. Results of their pregnancy have been followed-up, and pregnancy outcomes of 346 cases who were of low risk were followed-up at the same time. Results Among the 321 cases, there were 14 ca-ses of abortion because of PROM （ gestational age less than 28 weeks）;17 cases of premature delivery because of PROM, including 9 cases whose gestational age were from 28 to 34 weeks and 8 cases whose gestational age were from 34 weeks to 37 weeks;and 7 cases of neonatal asphyxia. In the low risk group, abortion because of PROM occured in 6 cases before 28 weeks, 3 cases between 28 to 34 weeks, and 4 ca-ses between 34 to 37 weeks, and neonatal asphyxia occured in 3 cases. Conclusion Comparing with Down’ s screening false positive preg-nant women and the low risk group, the false positive group have a higher occurrence of PROM, Down’ s screening is a potential high risk in-dex as a predictor of PROM.