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目的探讨不同孕期血清学产前筛查的实际效果。方法孕早期4297例孕妇采用PAPP-A+free-β-hCG血清标志物进行产前筛查,孕中期28490例孕妇采用free-β-hCG+AFP+uE3三联血清标志物进行产前筛查,筛查结果应用Lifecycle.3.0软件计算唐氏综合征及18三体危险概率。对高风险孕妇进行羊水或脐血细胞染色体分析。结果孕早期高风险孕妇157例,产前确诊唐氏综合征患儿3例,孕中期高风险孕妇1978例,确诊唐氏综合征患儿15例,18三体5例,13三体1例。在本研究中孕早期的筛查假阳性率为3.34%,而孕中期组假阳性率为6.74%,明显高于孕早期组(P<0.01),假阳性率下降了50.45%。结论孕早期筛查模式要优于孕中期,孕早期接受筛查可显著降低参加产前诊断人数,避免了不必要的胎儿丢失。
Objective To investigate the actual results of serological prenatal screening during different gestations. Methods 4297 pregnant women in the first trimester of pregnancy were tested by PAPP-A + free-β-hCG serum markers. 28,490 pregnant women at the second trimester were prenatal screening with free-β-hCG + AFP + uE3 triple serum markers, Screening Results Lifetime software was used to calculate Down’s syndrome and risk of trisomy 18 risk. Chromosomal analysis of amniotic fluid or cord blood cells in high-risk pregnant women. Results 157 pregnant women with high risk of early pregnancy, 3 children with Down Syndrome diagnosed prenatal, 1978 pregnant women with high risk of pregnancy, 15 children with Down syndrome, 5 18 cases of trisomy 18 and 1 case of 13 trisomy . In the first trimester of pregnancy, the false positive rate was 3.34%, while the false positive rate was 6.74% in the second trimester, which was significantly higher than that in the first trimester (P <0.01). The false positive rate decreased by 50.45%. Conclusion The screening model in early pregnancy is better than the second trimester. The screening in the first trimester can significantly reduce the number of prenatal diagnosis and avoid unnecessary loss of fetus.