孕中晚期终止妊娠原因分析

Termination reason of pregnancy in second and third trimester

目的研究本产前诊断中心就诊患者终止妊娠情况及原因分析。方法回顾性分析2004年至2015年底12年间到本产前诊断中心就诊却引产的病人716例,对其就诊原因,引产原因等情况进行分析。结果在716例引产病人中,因产前筛查高风险就诊346例,因高龄等原因在本院直接行产前诊断370例,查明染色体异常的有191例(26.68%),染色体正常223例(31.14%),未行染色体核型检查的302例(42.18%)。21三体、18三体、性染色体异常是终止妊娠最常见的染色体原因;染色体正常胎儿却终止妊娠的原因主要为在孕中期或孕晚期出现胎儿畸形;其次为孕妇原因。未行染色体检查而终止妊娠的主要原因为胎儿畸形或死胎。结论目前的染色体检查只能发现1/4的引产病人病因,不良妊娠病因的查明有待于更多遗传学检测方法的应用。

Objective：To investigate the rate and reasons of pregnancy termination in one prenatal diagnosis center during recent 12 years. Methods：The database of 716 cases of pregnancy termination from 2004 to 2015 were reviewed,to investigate the reasons for prenatal diagnosis,and the causes for termination. Results：Among 716 cases of pregnancy termination,346 cases were patients with high risk in prenatal screening,and 370 cases were patients with advanced maternal age and other abnormal indexes. 190（26.53%）cases had chromosome abnormality,223 cases（31.14%）had normal chromosome kayotypes,303（42.31%）cases didn′t carry on chromosome analysis. Trisomy 21,trisomy 18 and sex chromosome abnormalities were the most common types of chromosome abnormalities for termination of pregnancy. Congenital-malformations fetus and the healthy problem of the pregnancy women were the important reasons to termination in fetus with normal chromosome kayotypes. For the fetus who didn′t carry on chromosome analysis,the main reasons for termination were congenital malformations and stillbirth. Conclusion：Only about 1/4（26.53%）of cases of pregnancy termination were found due to chromosome abnormarlities, more advanced genetic tests need to adapted in the clinic to find the genetic causes of termination of pregnancy.