摘要
目的探讨产前诊断指征与羊水细胞染色体核型异常的相关性及羊膜腔穿刺术的安全性。方法选取2016年1-12月4 612例首都医科大学附属北京妇产医院有产前诊断指征的孕妇为研究对象。对孕妇进行羊膜腔穿刺及脐血穿刺,进行细胞染色体核型分析。比较不同产前诊断指征的染色体细胞核型异常率及羊膜腔穿刺与脐血穿刺的安全性。结果 4 612例入组孕妇中,高龄为指征的孕妇数量最多,占62.81%,其次为孕妇血清产前筛查高风险孕妇,占19.90%;4 612例入组孕妇中354例染色体异常,异常率为7.67%;产前胎儿超声检查异常者染色体异常率最高,达16.19%,明显高于其他产前诊断指征染色体异常率(P<0.05)。354例染色体异常胎儿进行核型分析,其中8例13-三体综合征,44例18-三体综合征;131例21-三体综合征,171例其他染色体异常。羊膜腔穿刺成功率为100%,细胞培养成功率为99.59%,脐血穿刺成功率为89.83%,细胞培养成功率为95.28%,两种穿刺成功率及细胞培养成功率比较差异无统计学意义(P>0.05)。羊膜腔穿刺并发症发生率为1.94%,脐血穿刺并发症发生率为14.41%,羊膜腔穿刺并发症发生率明显低于脐血管穿刺(P<0.05)。结论对具有产前诊断指征的孕妇进行羊膜腔穿刺,不仅可及时发现胎儿染色体异常,指导孕妇是否继续妊娠,还具有较高的安全性。
Objective To explore the correlation between prenatal diagnosis indications and abnormal karyotypes of amniotic fluid cells and the safety of amniocentesis.Methods A total of 4 612 pregnant women with prenatal diagnosis indications were selected from Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January to December in 2016,amniocentesis,umbilical cord puncture,and karyotyping of amniotic fluid cells were performed.The abnormal rates of chromosome karyotypes and the safety of amniocentesis and umbilical cord puncture were compared among the patients with different prenatal diagnosis indications.Results Among 4 612 pregnant women,62.81% of them had the prenatal diagnosis indication of advanced age,which was the highest,followed by pregnant women with high risk of serological prenatal screening,accounting for 19.90%.A total of 354 pregnant women were found with abnormal chromosomes,the incidence rate was 7.67%.Among the cases with abnormal results of prenatal fetal ultrasonography,the incidence rate of abnormal chromosomes was the highest,which was 16.19%,and it was statistically significantly higher than those of other prenatal diagnosis indications（P〈0.05）.A total of 354 cases underwent fetal karyotyping,then 8 cases with trisomy 13 syndrome,44 cases with trisomy 18 syndrome,131 cases with trisomy 21 syndrome,and 171 cases with other chromosomal abnormalities were found.The successful rates of amniocentesis and cell culture were 100% and 99.59%,respectively;the successful rates of umbilical cord puncture and cell culture were 89.83% and 95.28%,respectively;there was no statistically significant difference（P〉0.05）.The incidence rate of complications of amniocentesis was 1.94%,which was statistically significantly lower than that of umbilical cord puncture（14.41%）（P〈0.05）.Conclusion Amniocentesis used for pregnant women with prenatal diagnosis indications can timely find fetal chromosomal abnormalities and guide pregnancy,which has high safety.
出处
《中国妇幼保健》
CAS
2018年第2期381-384,共4页
Maternal and Child Health Care of China
关键词
产前诊断指征
羊膜腔穿刺
脐血穿刺
羊水细胞培养
染色体异常
Prenatal diagnosis indication
Amniocentesis
Umbilical cord puncture
Amniotic fluid cell culture
Chromosomal abnor-mality
