15486例孕中期筛查孕妇妊娠结局随访结果分析

A follow-up analysis of pregnancy outcomes in 15486 cases with prenatal screening

目的:探讨产前筛查及产前诊断在临床的应用及意义。方法:应用时间分辨荧光免疫法检测血清学三联指标(AFP+F-β-HCG+uE3)水平,Life-Cycle软件计算风险值;对产前筛查孕妇随访结果进行整理和分析。结果:15 486例孕妇中,血清学筛查高风险860例,筛查阳性率为5.55%;年龄高风险712例。高风险孕妇中575例(36.58%)选择产前诊断,羊水诊断检出21-三体8例、18-三体1例,产前超声诊断检出无脑儿1例。高风险孕妇不良妊娠结局发生率(5.36%)与低风险孕妇(2.02%)相比,差异有统计学意义(P<0.01);多种高风险孕妇不良妊娠结局发生率(26.92%)与仅21-三体或18-三体高风险孕妇(7.74%)相比,差异有统计学意义(P<0.01)。结论:产前筛查结果是预测染色体异常胎儿和不良妊娠结局的重要指标,结合产前诊断能有效防止出生缺陷发生;正确有效的随访对产前工作有重要意义。

Objective： To investigate the application and significance of prenatal screening and diagnosis. Methods： The serum samples were measured for the levels of human chorionic gonadotrophin free - β - subunit （F - β - hCG） , alpha - fetoprotein （AFP） and unconjugated estriol （ uE3 ） by using time - resolved fluoroimmunoassay. All the pregnancies who accepted second - trimester combined Down were found. The rate of adverse pregnancy outcomes with high risk was significantly higher than that for the pregnancies of low risk （5.36% vs 2. 02%, P 〈 0. 01 ） and multiple high risk was significantly higher than the pregnancies with high risk of DS or ES （7.74% vs 26. 92%, P 〈 0. 01 ） . Conclusion： Prenatal screening is an important indicator that forecasts chromosomal abnormalities fetus or adverse pregnancy outcomes, and an important tool combined with diagnosis to prevent the birth defect happened effectively. Only correct and effective follow - up can reflect and evaluate objectively the quality of screening.