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目的了解象山县产前筛查现状,探讨孕中期三联法产前筛查对发现胎儿异常、降低出生缺陷率的作用与意义。方法应用时间分辨荧光免疫方法 (DELFIA),检测孕中期母血清标志物甲胎蛋白(AFP)、游离β绒毛膜促性腺激素(Freeβ-hCG)和游离雌三醇(μE3)浓度(三联法),利用Lifecycle 3.0风险分析评估软件对胎儿患唐氏综合征(DS)、18-三体综合征(ES)及开放性神经管缺陷(NTD)的风险率进行综合评估,并随访妊娠结局。结果筛查20564例孕妇,其中年龄高风险(≥35周岁)1952例,血清高风险615例,血清阳性率3.30%。确诊DS5例,ES1例,NTD6例,畸形133例;17 997例低风险孕妇中,确诊DS1例,NTD1例,畸形377例,未检出ES。结论孕中期应用三联生化指标进行产前筛查是预测异常胎儿和不良妊娠结局的有效方法,但还存在一定的缺陷,必须寻找新的适宜的产前筛查方案,提高检出率,使人口缺陷干预工作得到良性循环。
Objective To understand the status quo of antenatal screening in Xiangshan County and to explore the effect and significance of prenatal screening in the second trimester of pregnancy on the detection of fetal abnormalities and birth defects rate. Methods The serum levels of AFP, Freeβ-hCG and μE3 in the second trimester of pregnancy were detected by the time-resolved fluorescence immunoassay (DELFIA) , Lifecycle 3.0 risk analysis software was used to assess the risk of fetal Down Syndrome (DS), 18-trisomy syndrome (ES) and open neural tube defects (NTD), and follow-up of pregnancy outcomes. Results Totally 20564 pregnant women were screened, among which 1952 were high-risk patients (≥35 years old), 615 were high-risk serums, and seroprevalence was 3.30%. DS5 cases, ES1 cases, NTD6 cases and malformations were diagnosed in DS5 cases. Among 17 997 low-risk pregnant women, DS1 cases, NTD1 cases and deformities were found in 377 cases without ES. Conclusion Prenatal screening with triple biochemical markers in the second trimester is an effective method to predict abnormal fetuses and adverse pregnancy outcomes. However, there are still some shortcomings. It is necessary to find a new prenatal screening program to improve the detection rate and make the population Defect intervention has been a virtuous circle.