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目的通过比较不同绒毛膜性对双胎早期唐氏筛查风险的影响,指导双胎早期唐氏筛查的风险计算。方法收集2014年7月至12月于湖南省妇幼保健院行唐氏筛查的170例自然妊娠双绒毛膜双羊膜囊双胎孕妇,用双绒毛膜双羊膜囊、单绒毛膜双羊膜囊及单绒毛膜单羊膜囊分别计算风险并追踪妊娠结局,比较用不同绒毛膜性进行风险计算所造成的差异。结果按双绒毛膜双羊膜囊、单绒毛膜双羊膜囊及单绒毛膜单羊膜囊计算的妊娠相关蛋白A中位数倍数(PAPP-A MOM)分别为2.19,1.20,1.37;人绒毛膜促性腺激素游离β亚基中位数倍数(free HCGβMOM)分别为2.02,1.09,1.36。按双绒毛膜双羊膜囊、单绒毛膜双羊膜囊及单绒毛膜单羊膜囊计算所得唐氏综合征高风险例数分别为13例、10例和7例,假阳性率分别为7.65%,5.88%,4.12%。追踪所有孕妇妊娠结局,其中双胎之一发生染色体异常者2例,双胎之一停育者2例,双胎停育者1例,1例双胎之一为心脏室间隔缺损,出生后行手术修补,1例双胎出生后均确诊为先天性甲状腺功能减低症。结论运用不同绒毛膜性进行双胎早期唐氏筛查风险计算,血清生化指标及风险值会发生显著变化,应按照孕妇真实情况详细描述双胎绒毛膜性,避免错误风险计算及漏筛情况的发生。
Objective To assess the risk of early Down’s screening of twin fetuses by comparing the effect of different chorionicities on the risk of Down’s screening of early twins. Methods A total of 170 pregnant women with natural pregnancy double chorion double amniotic sac were enrolled in the Down’s screening of maternal and child health hospital in Hunan Province from July to December 2014. The double amniotic sac, double chorioallantoic sac, Single chorionic single amniotic sacs were calculated for risk and follow-up of pregnancy outcomes compared with different chorionicities to calculate the differences caused by risk. Results The median multiple of pregnancy-associated protein A (PAPP-A MOM) was 2.19, 1.20, 1.37 calculated by double chorion, double chorioallantoic membrane and single chorioallantoic membrane, respectively. The human chorionic The median gonadal hormone free β subunits (free HCGβMOM) were 2.02,1.09,1.36 respectively. According to double chorion double amniotic sac, single chorion double amniotic sac and single chorionic amniotic sac, the high risk cases of Down’s syndrome were 13 cases, 10 cases and 7 cases respectively. The false positive rates were 7.65% 5.88%, 4.12%. All pregnant women were followed up for pregnancy outcome. One of the twins was found to have chromosomal abnormalities in 2 cases, one of the twins was disabled in 2 cases, twin twins in 1 case and one of the twins was a ventricular septal defect. After birth Surgical repair, a case of twin births were diagnosed as congenital hypothyroidism. Conclusions Using different chorionicities to calculate the risk of Down’s syndrome in early stage of twins, there are significant changes in serum biochemical indexes and risk values. The chorionicity of twins should be described in detail according to the actual situation of pregnant women. occur.