杭州萧山区7952例孕妇血清产前筛查结果与分娩结局的分析

The results and analysis on the prenatal screening for 7952 cases of pregnant women with serum in Xiaoshan area,Hangzhou

目的了解孕中期产前筛查对胎儿染色体异常及神经管缺陷的作用,以降低出生缺陷。方法应用时间分辨荧光免疫法对萧山区7952例孕15～19+6周孕妇血清AFP和Free-β-HCG进行产前筛查,同时对孕妇分娩结局进行随访结果。结果血清产前筛查7952人,高风险222例,高风险率为2.79%。其中21-三体综合征高风险189例;18-三体综合征高风险8例;NTD高风险25例。7952例月孕妇分娩随访结果显示:高风险222例中产前诊断羊水穿刺112例,羊水穿刺率50.45%。其中14人为高风险结局异常,异常发生率为6.30%;通过羊水穿刺检查及超声检查,发现3例21-三体综合征、1例心内膜缺损、染色体缢痕延长1例。低风险7730人中尚有96人为低风险分娩结局异常,占低风险人群的1.24%。以上共计110例结局异常分娩结局病例中,其中31例自然流产、医学终止妊娠41例、死胎19例、新生儿异常19例。结论产前筛查结合产前诊断对预防染色体异常和其他先天畸形儿的出生,具有重要作用。

Objective： To search the prenatal screening on second trimester fetus for fetal chromosomal abnormalities and neural tube defects, in order to reduce the birth deficiency. Methods： Time - resolved fluorescence immunoassay are used to tests the concentrations of AFP, Free - β - HCG in the serum of 7952 middle period pregnant women whose were pregnant for 15 - 19 weeks in Xiaoshan, and the childbirth of pregnant women were followed up. Results： 7952 pregnant women accepted prenatal screening, the high risk rate is 2. 79% （222/7952）. Among them, 189 cases indicate DS, 8 cases indicate 18 - trisomy, 25 cases indicate NTD. All pregnant women were follow - up and 112 cases were amniocentesis in 222 cases because of high risk. The rate of amniocentesis is 50. 45%. Abnormal incidence was 6. 30% （ 14/222 ） ; by the way of amniocentesis and ultrasound, 3 cases of 21 - trisomy syndrome, 1 case of endocardial defect and 1 caes of chromosome constriction extended were found. There are 96 low - risk abnormal labor from 7730 cases which are low - risk abnormalities, accounting for 1.24% of low - risk population. Than a total of 110 cases of abnormal birth, of which 31 cases of spontaneous abortion, 41 cases of medical termination of pregnancy, 19 cases of stillbirth, 19 cases of neonatal abnormalities. Conclusion ： The combination of prenatal screening and prenatal diagnosis are important for preventing the born of children with chromosomal abnormalities and other congenital malformations.