孕15～20+6周正常单胎和双胎妊娠孕妇血清学产前筛查结果分析

Analysis of maternal serum screening of pregnant women with normal singleton and twin pregnancies in15～20+6 weeks of gestation

目的分析孕15~20^+6周的孕妇血清标志物AFP、Freeβ-HCG、uE3在双胎和单胎妊娠孕妇体内的分布及中位数值水平的差异,为合理建立双胎妊娠各血清标志物各孕周中位数值提供依据。方法回顾性分析在本院就诊,知情同意行血清学产前筛查的孕15~20+6周的双胎妊娠孕妇和妊娠结局正常的单胎妊娠孕妇,比较单双胎妊娠孕妇体内各标志物的分布和中位数值差异。结果782例妊娠结局正常的双胎妊娠与15738例单胎妊娠的孕妇比较,双胎妊娠孕妇血清中各标志物变化趋势与单胎相似,AFP、Freeβ-HCG、uE3的中位数值比单胎分别高2.05、2.05、1.8。观察到的单双胎校正系数仅AFP和Freeβ-HCG有显著性差异(P<0.05)。结论孕15~20+6周双胎妊娠孕妇各血清标志物水平不完全为单胎妊娠孕妇的2倍,且与单胎妊娠中位数值无比例关系。基于单胎数据的筛查软件在对双胎筛查时应对不同孕周各标志物及孕妇体重进行合理校正。

Objective To analyze the distribution and median level of serum markers AFP, Freeβ-HCG and uE3 in pregnant women between 15~20 +6 weeks in twins and singletons. The median value of each gestational age of serum markers in pregnancy provides a basis. Methods Retrospective analysis of the hospital from January 2, 2013 to December 31, 2015, pregnant women with informed consent for prenatal screening for 15~20 +6 weeks of pregnancy and normal pregnancy outcomes Pregnant women with singleton pregnancy compared the distribution and median value of each marker in pregnant women with single pregnancy. Results 782 cases of twin pregnancy with normal pregnancy outcomes compared with 15738 single-pregnancy pregnant women, the trend of each marker in serum of pregnant women with twin pregnancy was similar to that of singleton, and the median ratio of AFP, Freeβ-HCG and uE3 The single tires were 2.05, 2.05, and 1.8 respectively. The observed single-double fetal correction coefficient was only significantly different between AFP and Freeβ-HCG ( P <0.05). Conclusions The serum levels of pregnant women in 15-20+6 weeks of twin pregnancy are not completely twice that of pregnant women with singleton pregnancy, and there is no proportional relationship with the median value of singleton pregnancy. Screening software based on single-fetal data should be properly calibrated for each marker and the weight of the pregnant woman during screening for twins.