南方医科大学学报Issue(7)：1059-1062,1072,5.DOI:10.3969/j.issn.1673-4254.2015.07.25
孕中期血清学筛查在产前诊断及妊娠结局预测中的应用
Serum marker screening during the second trimester for prenatal diagnosis and predicting pregnancy outcome
摘要
Abstract
Objective To explore the clinical value of screening the serum markers during the second trimester of pregnancy in preventing congenital birth defect and predicting the pregnancy outcome. Methods Between November, 2011 and October, 2013, a total of 25 520 pregnant women (15-20+6 gestational weeks) underwent a screening test of triple serum markers including free beta-human chorionic gonadotrophin (free β-hCG), alpha-fetoprotein (AFP), and unconjugated estriol (µE3) during the second semester of pregnancy. The women identified by the screening test as having high risks were referred to invasive prenatal diagnosis by amniocentesis, or to color Doppler ultrasound examination for suspected patent neural tube defect (NTD), and their pregnancy outcomes were followed up. Results High-risk pregnancies were identified by the screening test in 4.91%(1254/25520) of the total cohort. Of the 818 patients receiving invasive prenatal diagnosis, the abnormal rate was 5.75%(47/818). The high-risk pregnancies identified by the screening test was associated with a significantly higher rate of abnormal outcomes compared with the low-risk pregnancies (1.91%vs 0.1%, P<0.01). Of the 210 high-risk cases of NTD, a definite diagnosis was established in 34 cases. We also found that pregnancies at an advanced age (>35 years) was associated with increased risks for trisomy 21 compared with those at younger ages (15% vs 1.65%, P<0.01). The detection rate of abnormal karyotypes in pregnancies with an abnormal MoM value of a single marker was 3.17% (6/189). Conclusion Screening tests of serum markers during the second trimester of pregnancy can be helpful to identify fetal chromosomal and anatomical anomalies, predict unfavorable pregnancy outcomes, and prevent birth defects in pregnancies at an advanced age. The MoM value of a single marker in the second trimester can be indicative of potential chromosomal abnormalities.关键词
产前筛查/21三体综合征/18三体综合征/神经管缺陷/妊娠结局/MoM值Key words
prenatal screening/trisomy 21/trisomy 18/neural tube defect/pregnancy outcome/MoM value引用本文复制引用
杨岚,赵丽,江静颖,刘俊,陶荷花,王俊,吴金保..孕中期血清学筛查在产前诊断及妊娠结局预测中的应用[J].南方医科大学学报,2015,(7):1059-1062,1072,5.基金项目
江苏省妇幼保健重点资助项目（F201315）；无锡市科技局指令性项目（CSEYIN1109）；无锡市医管中心面上项目（YGZXM1510）；南京医科大学面上项目 （）
