413例胎儿脐血染色体异常相关因素的临床分析

Clinical Analysis of Chromosomal Abnormalities of 413 Cases by Puncturing Umbilical Cords

目的评价超声引导下脐血管穿刺术在产前诊断中的应用,探讨胎儿染色体异常的临床高危因素,提高脐血管穿刺对胎儿异常染色体核型的检出率。方法选取在我院超声引导下经腹脐血管穿刺并行染色体检查的孕妇413例,进行染色体核型分析,比较不同产前诊断指征组的异常染色体检出率及相关因素分析。结果穿刺成功率100%,胎儿脐血管穿刺的主要并发症为穿刺点出血41例,占9.92%;胎心心动过缓8例,占1.93%;胎儿丢失1例,占2.42‰。共检出异常染色体核型62例,检出率15.01%。发现同时合并两种以上指征者与胎儿染色体异常存在相关性(r=0.526,P=0.005)。结论脐血染色体核型分析能够为临床上诊断胎儿染色体异常提供可靠依据,但需要把握好手术指征及加强施术者的技术熟练程度。同时合并两种以上指征者很有必要进行产前诊断。

Objective To evaluate the application of ultrasound-guided umbilical vessel puncture in prenatal diagnosis,and assess the clinical risk factors of fetal chromosomal abnormalities,increased umbilical vessel puncture of fetal chromosomal abnormality detection rate.Methods 413 pregnant women were selected under the guidance of ultrasound in abdominal umbilical vessel puncture parallel chromosome examination,and karyotype analysis were done.To compare the different indications for prenatal diagnosis of chromosomal abnormalities in group of detection rate and related factors analysis.Results The success rate of puncture was 100%.Fetal umbilical vessel puncture complications were puncture site（41cases,9.92%） and fetal heart brachycranic（8cases,1.93%）.Fetal loss（1 cases,2.42‰）.62 chromosomal abnormalities were found and the detection rate was 15.01%.There was significant correlation between the couple＇s chromosomal abnormalities and the fetal′s（r=0.526 P=0.005）.Conclusions Umbilical cord blood karyotype analysis for clinical diagnosis of fetal chromosomal abnormalities and provide a reliable basis,but needs to grasp the operation indication and strengthen the performer skilled degree.especially when couples have more than two kinds of indications of chromosomal abnormalities.