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目的本文对产前筛查和诊断的流程进行修改,提出新的产前诊断的模式。方法采用多科会诊的形式简化了流程,从以下几方面分析应用效果:①是否有利于提高医疗质量和诊断的准确性;②患者的依从性、满意度及可接受的程度;③是否有利于提高专业人员的知识和技术水平。结果109例高危孕妇,本院建卡38例(34.9%),外院发现问题到本院就诊71例(65.1%)。其中92例(84.5%)为妊娠早中期超声筛查发现异常,头颈部13例,胸部13例,腹部15例,泌尿系统16例。胎盘异常4例,遗传疾病及多发畸形15例,各种高危因素16例。对于致死性胎儿疾病,经三位以上专家确认后终止妊娠;围产儿出生后可能存活的,产后儿科随访,并告知新生儿期就诊流程;在妊娠期或出生后需要及时干预的,制定治疗方案。其中6例在妊娠期制定围产儿处理方案,在新生儿期及时干预,4例预后良好。结论出生缺陷的产前筛查和诊断的新模式不仅优化就诊流程,而且提高了产前诊断的准确性和效率。
Objective This paper modifies the process of prenatal screening and diagnosis and proposes a new mode of prenatal diagnosis. Methods The procedure was simplified in the form of multidisciplinary consultations, analyzing the application effects from the following aspects: (1) whether it is conducive to improving the quality of medical care and the accuracy of diagnosis; (2) patient compliance, satisfaction and acceptability; (3) Improve the professional knowledge and skills. Results 109 cases of high-risk pregnant women, 38 cases of hospital card (34.9%), the hospital found that 71 cases (65.1%) were hospitalized. Among them, 92 cases (84.5%) were found abnormal by ultrasound screening in early and middle gestation. There were 13 cases of head and neck, 13 cases of thoracic, 15 cases of abdomen and 16 cases of urinary system. 4 cases of placental abnormalities, 15 cases of genetic diseases and multiple deformities, 16 cases of various risk factors. For the fatal fetal disease, confirmed by more than three experts after the termination of pregnancy; perinatal children may survive after birth, postpartum pediatric follow-up, and inform the neonatal treatment flow; in pregnancy or after birth need timely intervention, the development of treatment programs . 6 cases of perinatal treatment in the development of programs during pregnancy, timely intervention in the neonatal period, 4 patients with good prognosis. Conclusion The new mode of prenatal screening and diagnosis of birth defects not only optimizes the treatment flow but also improves the accuracy and efficiency of prenatal diagnosis.