孕中期血清学筛查高风险孕妇的不良妊娠结局分析  

Analysis on Adverse Pregnancy Outcomes of Serological Screening in the Second Trimester for Pregnant Women with High Risk

作　　者：杨黎明[1] 吕璇[1] 沈盼盼[1] 郭华峰[1] YANG Li-ming;Lü Xuan;SHEN Pan-pan(Prenatal Screening Laboratory Center,Zhengzhou Maternal and Child Health Hospital,Zhengzhou,450000,China;不详)

机构地区：[1]郑州市妇幼保健院,郑州450000

出　　处：《中国初级卫生保健》2020年第10期63-65,共3页Chinese Primary Health Care

基　　金：河南省医学科技攻关计划项目(2018020717)。

摘　　要：目的探讨和分析孕中期血清学筛查高风险孕妇的不良妊娠结局的类型和原因,指导再次妊娠,预防出生缺陷。方法通过医院围产医学门诊、住院病历、产前筛查中心以及超声科门诊查找胎儿、孕妇信息并对孕中期血清学筛查孕妇妊娠结局进行随访、追踪,获得研究数据。结果 4 457例高风险孕妇中,不良妊娠结局215例,占高风险人群的4.82%,流产或引产208例,出生7例。其中,胎儿染色体异常89例(41.40%),单纯的胎儿结构畸形62例(28.84%),包括心脏异常15例;自然流产/死胎37例(17.21%),未进行产前诊断,直接流产17例(7.91%),人为因素流产10例(4.64%)。结论高风险孕妇的不良妊娠结局以胎儿遗传因素为主,有不良妊娠史的妇女再次妊娠需要进行遗传咨询。OBJECTIVE To explore and analyze the types and causes of adverse pregnancy outcomes of serological screening in the sec⁃ond trimester for pregnant women with high risk,so as to guide second pregnancy and prevent birth defects.METHODS The study da⁃ta was obtained by seeking information about fetuses and pregnant women in the perinatal clinic,medical records,prenatal screening laboratory center and ultrasound clinic,and by following up and tracking their pregnancy outcomes.RESULTS Among 4457 high-risk pregnant women,215(4.82%)cases had adverse pregnancy outcomes,208(96.74%)cases had miscarriage or induced labor,and 7(3.26%)cases were born.In 215 cases of adverse pregnancy outcomes,89(41.40%)cases were diagnosed with chromosomal abnormali⁃ties,62 cases(28.84%)were diagnosed with single fetal structural malfo rmation,including 15 cases of abnormal heart.37(17.21%)cases were spontaneous abortion/stillbirth,17(7.91%)cases were direct abortion without prenatal diagnosis,and 10(4.64%)cases were artificial abortion.CONCLUSION The occurrence of adverse pregnancy outcomes in high-risk pregnant women was dominated by fetal genetic factors.Pregnant women with adverse pregnancy outcomes needed to undergo genetic counseling to re-pregnancy.

关 键 词：血清学筛查 高风险 不良妊娠结局 遗传咨询 

分 类 号：R714[医药卫生—妇产科学]