不同产前诊断临床指征与TORCH感染相关性的临床分析

Clinical analysis of the relationship between different prenatal diagnosis indications and TORCH infection

目的 探讨不同产前诊断脐带血穿刺临床指征与胎儿TORCH-IgM阳性的关系。方法 收集2020年2月至2021年2月在广州市妇女儿童医疗中心产前诊断中心接受孕期产前诊断咨询,且根据不同产前诊断临床指征行介入性脐带血穿刺术及脐带血TORCH-IgM检测的176例孕妇资料,对获得的脐带血行TORCH-IgM检查,并将TORCH阳性的脐带血进一步行巨细胞病毒(CMV)基因芯片检测分析。结果 对176例孕妇的介入性产前诊断脐带血穿刺术全部成功,其中前三位临床指征分别是侧脑室增宽(30.68%)、生长发育迟缓(21.02%)和脑部囊肿(蛛网膜囊肿及脉络丛囊肿)(6.82%);检出3例胎儿宫内TORCH感染,其产前诊断临床指征分别为2例胎儿心脏畸形、1例胎粪性腹膜炎,阳性率分别占所属临床指征的18.18%(2/11)和25.00%(1/4),感染率为1.70%(3/176)。结论 对有明确产前诊断临床指征的孕妇应选择适当的产前脐带血穿刺检测,以便及时发现胎儿宫内TORCH感染的情况。

Objective To explore the relationship between different prenatal diagnosis indications of umbilical cord blood puncture and TORCH-IgM infection.Methods According to different prenatal diagnosis indications, 176 pregnant women were enrolled cordocentesis in our hospital from February 2020 to February 2021,their cord blood samples were performed TORCH-IgM test, the positive samples in TORCH further detected and analyzed by cytomegalovirus(CMV) method.Results All performance of cordocentesis were successful, The top three clinical indications were lateral ventricle enlargement(30.68%),growth retardation(21.02%) and brain cysts(arachnoid cysts and choroid plexus cysts)(6.82%).Three cases of intrauterine TORCH infection were detected, and the clinical indications of prenatal diagnosis were 2 cases of fetal heart malformation and 1 case of meconium peritonitis, respectively.The positive rates were 18.18%(2/11) and 25.00%(1/4),and the infection rate was 1.70%(3/176).Conclusion In order to find out intrauterine TORCH infection in time, proper prenatal tests should performed for those pregnant women with prenatal diagnosis indications.