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目的分析湘潭市13家医院开展多种产前诊断后,围产期出生缺陷儿的转归变化情况。方法对湘潭市13家医院住院分娩及引产的孕20周~出生后7 d的围产儿进行出生缺陷监测及产前诊断并治疗性终止妊娠,统计描述和分析监测结果。结果 (1)在45 564例围产儿中监测到出生缺陷儿595例,出生缺陷发生率13.06‰。(2)产前诊断发现缺陷胎儿347例,检出率58.32%;其中9种严重缺陷胎儿产前检出率84.74%,28周前检出率51.95%。(3)有337例缺陷胎儿治疗性终止妊娠,占缺陷儿围产期死亡的93.39%,使存活儿中围产期出生缺陷发生率由13.06‰下降为5.66‰,严重出生缺陷在存活儿中排位后移;结论 (1)产前诊断并终止妊娠使出生缺陷在围生儿死亡中的比例增高,存活婴儿的出生缺陷发生率降低、顺位改变;(2)产前诊断使严重出生缺陷在分娩前及时终止妊娠,对提高出生人口素质有非常重要的意义。
Objective To analyze the change of outcome of perinatal birth defects in 13 hospitals in Xiangtan City after carrying out a variety of prenatal diagnosis. Methods Thirteen hospitals in Xiangtan City, hospital delivery and induction of labor for 20 weeks ~ 7 days after birth, birth defects monitoring and prenatal diagnosis and treatment of terminally terminated pregnancy, statistical description and analysis of monitoring results. Results (1) 595 cases of birth defects were detected in 45 564 cases of perinatal children, the incidence of birth defects was 13.06 ‰. (2) Prenatal diagnosis found 347 cases of defective fetuses, the detection rate was 58.32%; of which 9 kinds of serious defects fetus prenatal detection rate of 84.74%, 28 weeks before the detection rate of 51.95%. (3) 337 cases of fetal termination of pregnancy, accounting for 93.39% of the perinatal death, the incidence of perinatal birth defects in surviving children decreased from 13.06 ‰ to 5.66 ‰, severe birth defects in survivors (1) prenatal diagnosis and termination of pregnancy increased the proportion of birth defects in perinatal deaths, the incidence of birth defects in surviving infants reduced, the order of changes; (2) prenatal diagnosis of severe birth Defects in the timely termination of pregnancy before delivery, to improve the quality of the population of birth is very important.