摘要
目的:探讨羊膜腔穿刺产前诊断异常核型发生的频率、类型及其与产前诊断指征的关系,并对羊膜腔穿刺术的安全性进行评估。方法:回顾性分析我院2005年1月至2008年8月1180例羊膜腔穿刺的手术指征、不同指征的异常染色体检出率及穿刺相关并发症。结果:1180例羊膜腔穿刺产前诊断中,发现异常核型43例,异常检出率为3.6%。43例中染色体数目异常19例,占异常核型的44.2%,其中21-三体10例,占异常核型23.3%。异常染色体检出率由高到低依次为:夫妇一方染色体异常携带、不良孕产史、孕中期母血清血两联法筛查高风险、超声检查胎儿结构异常、孕妇高龄。高龄孕妇中21-三体检出率为0.5%(2/410),非高龄组为1.0%(8/770),P>0.05,差异无统计学意义。1180例羊膜腔穿刺产前诊断中共有5例流产,经分析其原因与羊膜腔穿刺无关。结论:超声引导下羊膜腔穿刺是一种安全可靠的产前诊断方法。严格把握产前诊断指征,积极实施二级干预是提高人口素质的重要措施。
Objective：The occurrence rate and the type of abnormal fetal chromosomal karyotypes by amniocentesis were investigated,the indication and safety of amniocentesis in prenatal diagnosis were evaluated.Methods：A retrospective review was done for 1180 pregnant women who had amniocentesis from January,2005 to August,2008.The indicaton,abnormal karyotypes detection rate,and procedure-related complications were reviewed.Results：Among 1180 cases,there were 43 abnormal chromosomal karyotypes（detective rate 3.6%）.For the 43 abnormal karyotypes,there were 19 cases of abnormal chromosome number（44.2%）,10 cases of trisomy 21（23.3%）.The detection rate order of chromosomal abnormalities was：one of the couple as chromosomal abnormality carrier,history of adverse-pregnant,abnormal maternal serum screening result,abnormal ultrasonography results,advanced maternal age.The detective rate of trisomy 21 in advanced maternal age group was 0.5%,while the detective rate was 1% in young pregnant women,but there was no statistical difference（P〉0.05）.Among the 1180 cases,there were 5 cases of spontaneous abortion,which is not rrelated with amniocentesis after investigation.Conclusions：Amniocentesis under ultrasound-guidence is a safe and reliable method for prenatal diagnosis.Indications of prenatal diagnosis should be strictly controlled to actively implement two-level intervention for improving population quality.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2010年第5期377-380,共4页
Journal of Practical Obstetrics and Gynecology
