1200例孕中期产前筛查结果的回顾性分析

目的：评价孕妇血清标记物（甲胎蛋白AFP、β-绒毛膜促性腺激素β-hCG和雌三醇uE3）的孕中期三联筛查在临床中的应用价值。方法：采用酶联免疫吸附法（ELISA）对1200例孕中期（14～22周）孕妇进行血清标记物AFP、β-hCG和uE3的检测,结合孕龄、孕周、体重等因素,经专门的筛查分析软件,计算唐氏综合征,18三体及神经管缺陷（NTD）的风险率。如孕妇为高风险,则进行胎儿的超声检查和染色体核型分析的产前诊断。结果：在1200例孕妇中,筛查高风险的孕妇有73例,其中唐氏综合征,18三体,NTD高风险孕妇分别为65例,5例和3例,假阳性率为6.08%（73/1200）。其中59例接受了产前诊断,占高风险孕妇的80.8%（59/73）。共检出1例唐氏综合征儿和1例无脑儿,未发现18三体,检出率为100%（2/2）,未有漏诊的情况。妊娠不良结局在筛查高风险组和低风险组的比率分别为17.1%和1.32%,两组有显著性差异（P〈0.01）。结论：利用孕妇血清标记物（AFP、β-hCG和uE3）的孕中期无创伤性产前筛查,结合产前诊断,对减少出生缺陷儿的出生,具有重要意义,并且高风险的筛查结果对胎儿的预后有一定的提示作用。

Prenatal Screening in Mid-Pregnancy Women：Analysis of 1200 Cases

Objective：To assess the value of triple test with three maternal serum markers：α-fetoprotein（AFP）,free-β-human chorionic gonadotrophin（free-β-hCG）and unconjugated estriol（uE3） in the second trimester prenatal screening.Methods：Prenatal serum screening were offered to the 14～22 weeks pregnant women by measuring the serum AFP,free-βhCG and uE3 with ELISA and calculating the risk by special software.If the risk is high,the pregnant women were advised to do prenatal diagnosis.Results：Within 1 200 cases of women,the cases in high risk are 73,including 65 cases in Down＇s syndrom,5 cases in 18-trisomy and 3 cases in neural tube defect.The false positive rate were 6.08%,and the detect rate were 100%（2/2）.1 case was confirmed the Down＇s syndrome by cytogenetics analysis,another 1 case was diagnosed the neural tube defect via ultrasonography.adverse obstetric outcome between high risk group and the low risk group were 17.1% and 1.32%,the difference was significant（P 0.01）.Conclusion：The prenatal screening with maternal serum markers：AFP,Free-βhCG and uE3 is an effective and safe screening strategy,and the high risk result is helpful in obstetric outcome.