早中孕联合筛查在降低出生缺陷中的价值与意义分析  

Value and Significance of Combined Screening in Early and Middle Pregnancy in Reducing Birth Defects

作　　者：赖春红 张丽娟 LAI Chunhong;ZHANG Lijuan(Ruijin Hospital of Traditional Chinese Medicine,Jiangxi Province,Ruijin 342500,China;不详)

机构地区：[1]江西省瑞金市中医院,江西瑞金342500

出　　处：《中国医学创新》2022年第30期57-61,共5页Medical Innovation of China

摘　　要：目的:探究早中孕联合筛查在降低出生缺陷中的价值与意义。方法:回顾性分析2018年10月-2021年10月在瑞金市中医院备孕门诊及产科门诊定期接受产前检查的单胎妊娠孕妇资料,分别于孕早期、孕中期对孕妇进行血清学筛查和超声检查,评估21-三体综合征、18-三体综合征和开放性神经管缺陷的风险度,分析孕早期、孕中期和早中孕联合筛查与出生缺陷、异常妊娠结局的关系;比较不同筛查方案对21-三体综合征、18-三体综合征和神经管缺陷产前筛查的诊断价值。结果:本研究共计进行血清学筛查572例,包括单独早孕筛查239例,单独中孕筛查112例,早中孕联合筛查221例。孕早期、孕中期和早中孕联合筛查阳性率比较,差异有统计学意义(P<0.05)。不同筛查方案中,高风险孕妇的出生缺陷发生率、异常妊娠结局发生率均高于低风险孕妇(P<0.05)。572例孕妇均完成随访,随访出生缺陷新生儿10例(1.75%),其中,21-三体综合征3例,18-三体综合征3例,开放性神经管缺陷4例。孕早期、孕中期和早中孕联合筛查对21-三体综合征的筛查准确率分别为90.79%、91.96%和97.74%;筛查18-三体综合征的准确率分别为89.96%、90.18%、92.31%;筛查开放性神经管缺陷的准确率分别为89.12%、88.39%和90.95%。结论:产前不同时期血清学筛查均有较高的阳性率,对高风险孕妇出生缺陷、异常妊娠结局的预判具有良好效果,早中孕联合筛查有利于21-三体综合征、18-三体综合征、开放性神经管缺陷等出生缺陷的筛查。Objective:To explore the value and significance of combined screening in early and middle pregnancy in reducing birth defects.Method:The data of singleton pregnant women who received regular prenatal examinations in the Pregnancy Preparation Clinic and Obstetrics Clinic of Ruijin Hospital of Traditional Chinese Medicine from October 2018 to October 2021 were retrospectively analyzed.Serological screening and ultrasonography were performed in early and middle pregnancy to assess the risks of trisomy 21,trisomy 18 and open neural tube defects.The relationship of screening in early pregnancy,screening in middle pregnancy,and combined screening in early and middle pregnancy with birth defects and abnormal pregnancy outcomes were analyzed.The value of different screening plans in prenatal screening of trisomy 21,trisomy 18 and neural tube defects were comparatively analyzed.Result:A total of 572 cases of serological screening were performed in this study,including 239 cases of screening in early pregnancy,112 cases of screening in middle pregnancy,and 221 cases of screening in combined screening in early and middle pregnancy.There were statistically significant differences in the positive rates of screening in early pregnancy,screening in middle pregnancy,and combined screening in early and middle pregnancy(P<0.05).In each screening plan,the incidence rates of birth defects and abnormal pregnancy outcomes in high-risk pregnant women were higher than those in low-risk ones(P<0.05).All 572 pregnant women completed follow-up,and 10(1.75%)neonates with birth defects were followed up,including 3 cases of trisomy 21,3 cases of trisomy 18,4 cases of open neural tube defects.The accuracy rates of screening in early pregnancy,screening in middle pregnancy and combined screening in early and middle pregnancy for trisomy 21 were 90.79%,91.96%and 97.74%.The accuracy rates for trisomy 18 were 89.96%,90.18%and 92.31%.The accuracy rates for open neural tube defects were 89.12%,88.39%and 90.95%.Conclusion:Serological screening in dif

关 键 词：出生缺陷 不良妊娠结局 孕早期 孕中期 血清学筛查 早中孕联合筛查 

分 类 号：R714.5[医药卫生—妇产科学]