孕中期唐氏筛查法在高龄孕妇中的意义分析

Significance of Down's Screening Method in Middle Pregnancy in Elderly Pregnant Women

目的探究唐氏筛查法在高龄孕妇妊娠中期的检出率及准确性。方法对2017年1月~2017年10月宜春市妇幼保健院215例进行产前检查的孕妇,运用时间分辨免疫荧光法对血清中的甲胎蛋白、人类绒毛膜性腺激素以及游离雌三醇浓度进行测定。经唐氏筛查法检查后提示唐氏综合征高风险者,进行羊水染色体核型检查,分析比较两组孕妇的唐氏筛查高风险率以及染色体异常率。结果在200例符合纳入标准的孕妇中,经唐氏筛查共检出高风险孕妇15例,适龄组高风险检出率7例(4.60%)低于高龄组8例(16.67%),差异有统计学意义(P<0.05)。高风险孕妇经羊水染色体核型检查后发现唐氏综合征胎儿1例,该例患儿母亲为高龄孕妇,已在18孕周时进行引产。产后随访其他新生儿均未出现上述疾病。高风险胎儿其染色体异常率高于低风险胎儿,差异有统计学意义(P<0.05)。结论随着孕妇年龄的增加,唐氏筛查的高风险检出率明显增高,同时经唐氏筛查法提示高风险胎儿其染色体异常率明显高于低风险胎儿,因此妊娠中期应用唐氏筛查法评估异常胎儿情况对高龄孕妇有重要意义。

Objective To investigate the detection rate and accuracy of Down's screening method in middle-pregnancy pregnant women.Methods From January 2017 to October 2017,215 pregnant women undergoing prenatal examination in Yichun Maternal and Child Health Hospital determined the concentration of alpha fetoprotein,human chorionic gonadotropin,and free estriol in serum by time-resolved immunofluorescence.After screening by Down's screening test,suggesting that the high risk of Down's syndrome,amniotic fluid chromosome karyotype examination,analysis of the two groups of pregnant women with Down's screening high risk rate and chromosomal abnormalities.Results Among the 200 pregnant women who met the inclusion criteria,15 high-risk pregnant women were detected through Down's screening.The high risk detection rate in the age group was 7 cases(4.60%)lower than that in the elderly group 8 cases(16.67%),and the difference was statistically significant(P<0.05).High risk pregnant women were found to have 1 cases of Down's syndrome after amniotic fluid karyotype examination.The mother of this case was an elderly pregnant woman who had induced labor at 18 gestational weeks.No other diseases were found in other neonates.The chromosomal abnormality rate of high-risk fetus was higher than that of low risk fetus,the difference was statistically significant(P<0.05).Conclusion With the increase of pregnant women's age,the rate of high risk detection in down screening is obviously higher.At the same time,the rate of chromosomal abnormality in high risk fetus is obviously higher than that of low risk fetus by down screening method.Therefore,the application of down screening method in the mid-term pregnancy is of great significance for the elderly pregnant women.