孕中期血清学筛查在产前诊断和妊娠结局预测中的应用价值分析

陈曼娜

【摘要】目的：分析孕中期血清学筛查在产前诊断和妊娠结局预测中的应用价值。方法：入选2018年11月至2019年4月的孕妇1 292例，分别进行了AFP和f-βhcG的产前血清学筛查，分析产前诊断结果及对妊娠结局的预测结果。结果：21-三体综合征高风险的比例为2.87 %，18-三体综合征的高风险比例为0.54 %，ONTD高风险比例为0.70 %。高风险孕妇中年龄≥35岁的孕妇35例，高风险孕妇中年龄<35岁的孕妇18例，差异有统计学的意义（P<0.05）。年龄≥35岁的高风险孕妇中发生染色体异常的比例为34.29%，高于年龄<35岁的高风险孕妇中发生染色体异常的比例11.11 %，差异有统计学的意义（P<0.05）。年龄≥35岁的高风险孕妇中不良妊娠结局的发生率为22.86 %，高于年龄<35岁的高风险孕妇中不良妊娠结局的发生率5.56 %，差异有统计学的意义（P<0.05）。结论：孕中期血清学筛查在产前诊断和妊娠结局预测中的应用价值较高，特别是高龄产妇的预测价值更高，推荐在临床中广泛的应用。

【关键词】孕中期；血清学筛查；产前诊断；妊娠结局

[中图分类号]R714 [文献标识码]A [文章编号]2096-5249（2021）05-0130-02

Application value of serological screening in the second trimester of pregnancy in prenatal diagnosis and pregnancy outcome prediction

CHEN Man-na （Chaozhou people’s Hospital， Chaozhou Guangdong 521000， China）

[Abstract] Objective： to analyze the application value of serological screening in the second trimester of pregnancy in prenatal diagnosis and pregnancy outcome prediction. Methods： a total of 1292 pregnant women from November 2018 to April 2019 were enrolled in this study. The prenatal serological screening of AFP and F - β hCG were performed respectively， and the results of prenatal diagnosis and prediction of pregnancy outcome were analyzed. Results： the high risk rate of trisomy 21 was 2.87%， trisomy 18 was 0.54%， and ontd was 0.70%. Among the high-risk pregnant women， there were 35 cases with age ≥ 35 years old and 18 cases with age<35 years old. The difference was statistically significant （P<0.05）. The proportion of chromosomal abnormalities in high-risk pregnant women aged over 35 years was 34.29%， which was higher than that in high-risk pregnant women aged less than 35 years （11.11%）. The difference was statistically significant（P<0.05）. The incidence of adverse pregnancy outcomes was 22.86% in high-risk pregnant women over 35 years old， which was higher than 5.56% in highrisk pregnant women under 35 years old （P<0.05）. Conclusion： the application value of serological screening in the second trimester of pregnancy is higher in prenatal diagnosis and pregnancy outcome prediction， especially in elderly women， so it is recommended to be widely used in clinical practice.

[Key words] second trimester； serological screening； prenatal diagnosis； pregnancy outcome

新生兒畸形严重影响新生儿的质量，同时也给新生儿的家庭带来比较重的经济和心理负担，随着环境污染的加重，不良的生活饮食的习惯等，新生儿的畸形在临床上的发生率也在增加，因此，对胎儿的染色体的异常，神经管的缺陷等进行一定的产前评价直接影响新生儿的出生质量，可减少新生儿缺陷的发生，具有重要的临床意义[1-3]。目前，在新生儿缺陷方面的预测评估可以采取妊娠中期的血清学检查与诊断的方式，通过对孕中期的孕妇的血清学的诊断，分析唐氏综合征，神经管缺陷等的发生风险，可以及时的终止不良检查结果的孕妇的妊娠，避免出现新生儿缺陷和不良的妊娠结局[4-6]。……