1318例发育异常和高危胎儿产前诊断及处理的结局分析

Analysis of 1318 cases prenatal diagnosis and anteratal care. process

目的分析1318例发育异常和高危胎儿产前诊断及处理的结局,总结异常和高危胎儿产前诊断、围产期监护和处理、出生后衔接治疗流程,以探讨适合目前国内医疗水平的胎儿医学模式。方法对在本院和外院转送经常规产检筛查:发现孕期孕母高龄或血清唐氏风险高、TORCH感染、RH(-)、父母双方地贫携带者等孕期胎儿高危因素者1123例和B超影象发现结构异常的胎儿195例进行①介入性产前诊断检查染色体、TORCH等;②预后评估;③围产期监护;④分娩后衔接处理;⑤新生儿期跟踪处理;⑥定期随访与总结。结果产前诊断结果胎儿重型a地贫39/276,重型B地贫18/236;TORCH感染11/229例;母RH(-)5例,1/5例胎儿严重水肿引产,1/5例胎儿黄疸;染色体异常19例,其中7/377例为母高龄或血清筛查唐氏风险高,11/195例为胎儿结构异常;单纯胎儿结构异常62例引产放弃,2/195 TORCH感染,引产;120例期待观察,其中68例手术治疗,7例治疗失败,其余胎儿均获得良好愈后。结论异常和高危胎儿可通过产前诊断、医学评估、宫内监护、出生后治疗处理获得良好和合理结局。

Objective： To study the clinical model of fetal medine in china by analysis 1318 case process with hight- risk fetuses result of prenatal diagnosis and anteratal and outcome care. Methods ： prenatal diagnosis and medical assessment and anteratal or outcome care process were done on fetuses with hight -risk Down＇s and TORCH infection and serious thalassemia and rhesus alloimmunization and anomalous picture in ultrasound and so on. Results ： TORCH infectionl 1/229, serious thalassemia, chromosomal abnormalities 7/377 in hight - risk Down＇s screening and 2/195 in fetuses with anomalous picture in ultrasound. 62/195abortion, Anteratal care were done 120/195, 68/120 were treatment by surgery after birth and 7/68 were fail. Conclusion： Fetuses with hight - risk may obtain benefit from prenatal diagnosis and medical assessmentw and anteratal or outcome care process.