孕前及孕早期妇女TORCH筛查情况分析及临床意义

Analysis and clinical significance of TORCH screening in pre-pregnancy and early pregnancy women before

目的分析孕前及孕早期行弓形虫、风疹病毒、巨细胞病毒和单纯疱疹病毒(TORCH)筛查结果及妊娠结局,分析孕前孕早期行TORCH筛查的临床意义,促进母婴健康水平,提升优生优育水平。方法纳入2013年1月-2018年6月在安徽省计划生育科学技术研究所医院行孕前及孕期保健且符合条件的女性2118例作为研究对象,所有孕妇均于孕前3个月及妊娠后在该院建档行孕前孕期保健。其中1093例于孕前及孕早期保健均做了TORCH筛查设为孕前孕早期筛查组,1025例仅在孕早期行TORCH筛查设为孕早期筛查组。选择同期在该院分娩但未行孕前和孕早期TORCH筛查的826例产妇作为对照组。比较孕前孕期建档的两组孕妇TORCH检出结果及处理措施,比较3组母婴妊娠结局。结果三组孕妇年龄、孕次、产次、分娩方式比较差异无统计学意义(P> 0. 05)。孕前孕早期筛查组孕前TORCH筛查阳性102例,阳性率9. 33%,均采取对应治疗措施复查阴性后再孕,孕早期再行TORCH筛查,出现20例TORCH阳性,经治疗复查后9例终止妊娠。孕早期筛查组共筛查出TORCH阳性106例,阳性率10. 34%。其中8例根据医生建议终止妊娠,98例观察下继续妊娠。三组孕妇妊娠结局比较,对照组孕妇及胎儿新生儿不良妊娠率明显高于孕前孕早期筛查组,孕早期筛查组明显高于孕前孕早期筛查组(P <0. 05)。结论孕前孕早期行TORCH筛查,TORCH阳性者可及时采取对症措施提高妊娠安全性,有效降低妊娠不良结局率,提升优生优育水平,具有较高的临床价值。

Objective To analyze the results and pregnancy outcomes of toxoplasma gondii,rubella virus,cytomegalovirus and herpes simplex virus(TORCH)screening among pre-pregnancy and early pregnancy women,and to analyze the clinical significance of TORCH screening in early pregnancy,so as to promote maternal and infant health level and improve the quality of prenatal and postnatal care.Methods A total of 2118 eligible women who received pre-pregnancy and pregnancy care in our hospital from January2013 to June 2018 were included as study subjects.All pregnant women received pre-pregnancy care and prenatal care in our hospital for 3 months before and after pregnancy.Among them,1093 cases were screened for TORCH before pregnancy and early pregnancy,and 1025 cases were screened for TORCH only in the early stage of pregnancy.Among them,1093 cases received TORCH screening in pre-pregnancy and early pregnancy health care as the pre-pregnancy early pregnancy screening group,and 1025 cases received TORCH screening only in the early trimester of pregnancy as the early pregnancy screening group.The 826 women who delivered in our hospital at the same time but did not receive TORCH screening before pregnancy and early pregnancy were selected as the control group.Compared the detection results and management measures of two groups of maternal TORCH,and compared the maternal and infant pregnancy outcomes of the three groups.Results There was no significant difference in age,gestational age,number of births and delivery modes among the three groups(P>0.05).In the early pregnancy screening group,there were 102 cases of positive TORCH screening before pregnancy,with a positive rate of 9.33%.All of them adopted corresponding treatment measures to reexamine the pregnancy after negative;in the early pregnancy,there were 20 cases of positive TORCH screening,and 9 cases of pregnancy terminated after reexamination after treatment.A total of 106 TORCH positive cases were detected in the early pregnancy screening group,with a positive rate of 10.34%.Eight of them terminated their pregnancies according to the doctor’s advice,and 98 continued their pregnancies under observation.Comparison of pregnancy outcomes among the three groups showed that the rate of adverse pregnancy in the control group was significantly higher than that in the pre-pregnancy and early pregnancy screening group,and that in the early pregnancy screening group was significantly higher than that in the pre-pregnancy and early pregnancy screening group(P<0.05).Conclusion TORCH screening in the early stage of pregnancy has high clinical value in improving the safety of pregnancy,effectively reducing the rate of adverse pregnancy outcomes and improving the level of prenatal and postnatal care.