425例胎儿畸形治疗性引产的临床分析  

Clinical analysis of 425 fetal malformation cases with therapeutic induced labor

作　　者：陈杨萍 徐峰 徐雪琴 杨雪梅 CHEN Yang-ping;XU Feng;XU Xue-qin;YANG Xue-mei(Department of Obsterics and Gynecology,Wen Zhou Central Hospital,Zhe Jiang,Wenzhou 325000;Department of Prenatal Diagnosis Center,Wen Zhou Central Hospital,Zhe Jiang,Wenzhou 325000)

机构地区：[1]温州市中心医院妇产科,浙江温州325000 [2]温州市中心医院产前诊断中心,浙江温州325000

出　　处：《中国优生与遗传杂志》2020年第2期214-216,218,共4页Chinese Journal of Birth Health & Heredity

基　　金：2018年温州市科技局基础性医疗卫生科技项目(项目编号Y20180300);2019年温州市科技局基础性医疗卫生科技项目(项目编号Y20190010)。

摘　　要：目的了解胎儿畸形的发生率、发生顺位,探讨胎儿畸形发生的相关因素,为预防胎儿畸形的临床咨询提供依据。方法回顾分析2017年1月至12月份在本院因胎儿畸形而引产的425例孕妇的病历资料,同时随机抽取425例于同期分娩正常新生儿的产妇为对照组,通过出生缺陷报告卡和电话随访获得相关信息进行统计分析。结果 425例胎儿畸形引产中超声异常为254例,占59.76%,染色体异常为132例,占31.05%,超声及染色体均异常为37例,占8.7%,另有两例因中重度地中海贫血引产。在染色体异常的孕妇中,≥40岁的孕妇异常率最高10.10%,≥35~40岁的孕妇异常率次之2.58%,不同年龄段之间差异具有统计学意义(P<0.05)。病例组与对照组在高龄、服用叶酸、不良孕产史、不良工作环境、吸烟及是否正规产检方面的差异具有统计学意义。胎儿超声畸形中以多系统畸形比例最高,中枢神经系统畸形居第二位,心脏畸形居第三位。结论高龄是胎儿染色体异常的高危因素,不良孕产史、吸烟、高龄及不良工作环境是胎儿出生缺陷的高危因素。要重视出生缺陷的一级预防,孕早期服用叶酸,正规产前检查,及早发现胎儿畸形,适时选择性终止妊娠,避免给社会和家庭造成严重的负担。Objective:To understand the incidence and order of fetal malformation,explore the related factors of fetal malformation,and provide the clinical consulting evidence of prevent the fatal malformation.Methods:We have retrospective analyzed the medical records of 425 pregnant women who were induced by fetal malformation in our hospital from January 2017 to December and compared with randomly 425 pregnant women who delivered normal newborns during the same period.We made statistical analysis of relevant information which obtained through birth defect report card and telephone follow-up.Results:In 425 cases of fetal malformation induction,ultrasound abnormalities were 254 cases,59.76%,chromosome abnormalities were 132 cases,31.05%,and both abnormalities were 37 cases,accounting for 8.7%.There were another two induced cases because of moderate and severe thalassemia.Among the chromosome abnormalities,the highest abnormal rate was the group whose age were grater than or equal to 40 years,which was 10.10%.The group whose age was greater than or equal to 35-40 years old was the second,accounting for 31.05%.The differences between different age groups were statistically significant(P<0.05).The difference between the case group and the control group in old age,taking folic acid,bad pregnancy history,bad working environment,smoking and whether the formal birth test was statistically significant.In ultrasound abnormalities,the highest portions were multiple system deformities,central nervous system malformation and cardiac malformation.Conclusion:Old age was the risk factor of the chromosome abnormality.Bad pregnancy history,bad working environment,smoking and old age were the risk factors of fetal malformations.We should pay attention to primary prevention,taking folic acid in early pregnancy and regular prenatal examination.In order to avoid serious social and family burden,we should have early detection of fetal malformaitons and timely selective termination of pregnancy.

关 键 词：出生缺陷 相关因素 干预措施 

分 类 号：R726.2[医药卫生—儿科]