中孕期胎儿出生缺陷的临床监测及诊断分析  

Analysis of birth defects in the second trimester of pregnancy

作　　者：杨玲[1] 朱湘玉[1] 郑明明[1] 顾宁[1] 李洁[1] 王志群[1] 戴毅敏[1] Yang Ling;Zhu Xiangyu;Zheng Mingming(Department of Obstetrics and Gynecology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008)

机构地区：[1]南京大学医学院附属鼓楼医院妇产科

出　　处：《现代妇产科进展》2020年第3期177-180,共4页Progress in Obstetrics and Gynecology

基　　金：江苏省产科临床医学中心(创新平台)建设单位(苏卫科教[2016]17号)

摘　　要：目的:分析中孕期胎儿出生缺陷(BDs)的发病情况及人口特征的变化趋势,探讨目前产前诊断技术应用对中孕期因胎儿BDs终止妊娠的影响。方法回顾分析2014年至2018年546例孕14~27+6周因胎儿BDs终止妊娠的临床资料。结果排列前三位的中孕期BDs病种分别是先天性心脏病(CHD)(191例,占35.0%)、染色体异常(97例,占17.8%)、神经管畸形(96例,占17.6%)。2014年至2018年,中孕期胎儿BDs的产妇年龄≥35岁、产次为1、孕周<16+6周以及完成遗传学诊断者的比例逐年上升(P<0.05)。CHD中诊断孕周在13+6周前、以NT为前驱发现方法的病例及高危病例占比升高(P<0.05)。结论我国生育政策开放后,因中孕期BDs终止妊娠的产妇中,高龄、多产次及小孕周者增多,BDs的严重程度增加。重视孕早期的产前诊断可明显降低中孕期BDs胎儿。Objective:To analyze the incidence and demographic characteristics of birth defects(BDs)of fetus in the second trimester in past five years,and to explore the effect of current prenatal diagnostic techniques on the termination of pregnancy due to fetal BDs during the second trimester.Method:Retrospective analysis 546 cases of pregnancy termination due to BDs in 14~27+6 weeks of inpatient pregnancy in Nanjing drum tower hospital from 2014 to 2018.Results:The top three mid-pregnancy BDs were congenital heart disease(CHD),chromosomal abnormalities and neural tube defects.The proportion of BDs during mid-pregnancy maternal age≥35 years old,production one time,gestational age≤16+6 weeks and perfect genetic diagnosis had increased year by year(P<0.05).In CHD,the proportion of diagnosed 13+6 weeks ago,NT diagnosed cases and high-risk cases increased(P<0.05).Conclusions:After the opening of the fertility policy in China,among the patients who died of fetal BDs during the second trimester,the number of elderly,prolific the little gestational weeks women increased,and the severity of BDs increased.Paying attention to the prenatal diagnosis in the early pregnancy can significantly reduce the gestational age of the BDs.

关 键 词：出生缺陷 中孕期 生育政策 

分 类 号：R714.7[医药卫生—妇产科学]