单绒毛膜性双胎选择性胎儿宫内生长受限一胎停育的产前唐氏筛查分析  

Prenatal screening and analysis of Down's syndrome in monochorionic twin pregnancy with selective intrauterine fetal growth restriction or one fetal diapause

作　　者：陈怡博[1] 庄丹燕[1] 陈志央[1] 潘婕文[1] 余颀[1] 王飞[1] 

机构地区：[1]宁波市母胎医学研究重点实验室(宁波市妇女儿童医院检验科),浙江宁波315010

出　　处：《中国卫生检验杂志》2016年第19期2813-2815,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的比较分析单绒毛膜性双胎s IUGR一胎停育产前唐氏筛查母血清学生化指标与单胎妊娠差异,为产前筛查工作提供帮助。方法收集s IUGR一胎停育的孕妇资料109例,采用成组t检验和非参数秩和检验分别与单胎妊娠孕妇比较早孕期、中孕期母血清学生化指标。结果 s IUGR一胎停育孕妇分别与单胎妊娠孕妇比较,预产年龄、采血体重、采血孕周、分娩孕周、新生儿出生体重差异均无统计学意义（P〉0.05）,游离β-HCG、uE3差异无统计学意义（P〉0.05）,AFP差异有统计学意义（Z=4.589,P=0.000）,PAPP-A差异有统计学意义（Z=3.121,P=0.000）,一胎停育按照单胎双胎计算唐氏风险比较,中孕期风险和整合筛查风险差异均有统计学意义（χ~2值分别为14.811、7.803,P〈0.05）。结论停育孕周〈14周的s IUGR一胎停育中孕、整合唐氏筛查风险计算时应参照单胎妊娠计算较为合理。Objective To assess the biochemical markers of mother blood in the prenatal screening of Down’s syndrome in monochorionic twin pregnancy with selective intrauterine fetal growth restriction（ s IUGR） or one fetal diapause,and to analyze the difference with monocyesis,so as to provide help for the prenatal screening. Methods 109 cases of s IUGR or one fetal diapause were collected. The t test and non parametric rank test were used to detect and compare the maternal serum biochemical indexes in the early and middle pregnancy of monocyesis. Results The data of s IUGR or one fetal diapause and monocyesis were compared,and there was no satictical significance on the differences in pregnancy age,blood sampling weight,gestational week of blood sampling,gestational week of delivery,birth weight of newborn,with the differences statistically significant（ P 〉0. 05）. There was no statistical significance on difference between free β-h CG and u E3（ P 〉 0. 05）. There was satictical significance on the difference of AFP（ Z = 4. 589,P = 0. 000）,so was there on the difference of PAPP-A（ Z = 3. 121,P =0. 000）. Down’s risk comparison of one fetal diapause between in twin pregnancy and monocyesis showed that there was statistical significance on the difference between the risk in the second trimester of pregnancy and the integration screening risk（ χ2=14. 811,7. 803,P 〈 0. 05）. Conclusion The Down’s syndrome risk of second trimester screening and integrated screening should be calculated according to monocyesis in s IUGR and one fetal dispause within 14 weeks.

关 键 词：唐氏综合征 筛查 消失双胎 选择性胎儿宫内生长受限 

分 类 号：R714.5[医药卫生—妇产科学]