目的 依据唐氏筛查结果,探讨唐氏筛查的临床应用价值,并对唐氏筛查不同风险的不良妊娠结局进行比较。方法 回顾性分析本院2014年11月1日至2019年3月31日19 630名孕中期(14 W至21 W⁺⁶)孕妇的唐氏筛查结果,分别统计三种疾病(21-三体综合征、18-三体综合征、OSB)的高风险和临界风险的阳性率,以及随访所有孕妇分娩后高风险组、临界风险组、低风险组的不良妊娠发生率。结果 19 630例孕中期产前筛查结果中,21-三体高风险阳性率6.40%,21-三体临界风险阳性率为 14.6%。18-三体高风险阳性率0.17%,18-三体临界风险阳性率为0.28%。OSB高风险阳性率1.44%,21-三体、18-三体、OSB均为低风险的孕妇阳性率77.1%。随访和比较高风险组、临界风险组、低风险组孕妇的妊娠结局,其中高风险组不良妊娠发生率为1.97%,临界风险组不良妊娠发生率为0.72%,低风险组不良妊娠发生率为0。对三组不良妊娠结局发生率进行比较,差异有统计学意义(P<0.01)。高风险组不良妊娠发生率高于临界风险组不良妊娠发生率,临界风险组不良妊娠发生率高于低风险组不良妊娠发生率。结论 临界风险孕妇和高风险孕妇一样要高度重视,这部分孕妇有必要进行后续的超声检测、无创胎儿DNA筛查、以及羊水细胞核型分析,从而尽早发现出生缺陷儿。

Objective To explore the clinical application value of Down's screening according to the results of Down's screening, and to compare the adverse pregnancy outcomes of different risks of Down's screening. Methods The Down's screening results of 19630 pregnant women in the second trimester (14w-21w + 6) from November 1, 2014 to March 31, 2019 were analyzed retrospectively.The positive rates of high risk and critical risk of three diseases (21-trisomy syndrome, 18-trisomy syndrome, OSB) were counted respectively, and the incidence of adverse pregnancy in the high-risk group, critical risk group and low-risk group were followed up. Results Among 19630 cases of prenatal screening in the second trimester, the positive rate of 21 trisomy high risk was 6.40%, and the positive rate of 21 trisomy critical risk was 14.6%.The high-risk positive rate of 18 trisomy was 0.17%, and the critical risk positive rate of 18 trisomy was 0.28%.The high-risk positive rate of OSB was 1.44%, and the positive rate of 21 trisomy, 18 trisomy and OSB were 77.1%.Follow up and compare the pregnancy outcomes of high-risk group, critical risk group and low-risk group.The incidence of adverse pregnancy in high-risk group was 1.97%, that in critical risk group was 0.72%, and that in low-risk group was 0.The incidence of adverse pregnancy outcomes in the three groups were compared, the difference was statistically significant (P< 0.01).The incidence of adverse pregnancy in the high-risk group was higher than that in the critical risk group, and the incidence of adverse pregnancy in the critical risk group was higher than that in the low-risk group. Conclusion Critical risk pregnant women and high-risk pregnant women should pay attention to the same, critical risk pregnant women need to carry out follow-up ultrasound testing, non-invasive fetal DNA screening, and amniotic fluid cell nuclear type analysis, so as to find birth defects as early as possible.