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[南日德兰郡先天性异常和唐氏综合征的母血清筛查。八年经验]

[Maternal serum screening for congenital abnormalities and Down syndrome in Sønderjylland County. Eight years of experience].

作者信息

Christiansen M, Petersen P L, Permin M, Larsen L A, Nørgaard-Pedersen B

机构信息

Sønderborg Sygehus, gynaekologisk-obstetrisk afdeling.

出版信息

Ugeskr Laeger. 1999 Dec 13;161(50):6928-34.

Abstract

From January 1991 to December 1998 second-trimester maternal serum screening (Doubletest and Tripletest) for malformations and Down syndrome has been offered to pregnant women younger than 35 years of age living in Sønderjyllands county, Denmark. Follow-up of all cases of chromosome abnormalities and severe foetal malformations identified pre- or postnatally has been carried out. A total of 17,023 women were screened. Sixty-eight percent (17/25) of Down Syndrome pregnancies were detected. Three percent of the screened women were offered an amniocentesis due to a calculated risk of DS greater than 1:400 at birth. The positive predictive value was 1:30. For the three-year period 1996-1998 (Tripletest) the results were more promising: 91% (10/11) were detected, 3.9% were offered an amniocentesis, the positive predictive value was 1:21. In the eight-year period 80% (8/10) of the spina bifida cases were detected, all the cases (6/6) of anencephaly and 75% (6/8) of abdominal wall defects. One point six percent of the screened women were offered an amniocentesis due to high risk of a neural tube defect. The results confirm that second trimester maternal serum screening is a reliable method for determining the risk of severe foetal malformations and Down syndrome.

摘要

1991年1月至1998年12月期间,丹麦南日德兰郡为35岁以下的孕妇提供了孕中期母体血清筛查(双联试验和三联试验),以检测胎儿畸形和唐氏综合征。对产前或产后确诊的所有染色体异常和严重胎儿畸形病例进行了随访。共有17,023名妇女接受了筛查。检测出68%(17/25)的唐氏综合征妊娠病例。由于计算得出出生时患唐氏综合征的风险大于1:400,3%接受筛查的妇女被建议进行羊水穿刺。阳性预测值为1:30。在1996 - 1998年的三年期间(三联试验),结果更令人满意:91%(10/11)的病例被检测出来,3.9%的妇女被建议进行羊水穿刺,阳性预测值为1:21。在八年期间,80%(8/10)的脊柱裂病例被检测出来,所有无脑儿病例(6/6)以及75%(6/8)的腹壁缺陷病例被检测出来。由于神经管缺陷风险高,1.6%接受筛查的妇女被建议进行羊水穿刺。结果证实,孕中期母体血清筛查是确定严重胎儿畸形和唐氏综合征风险的可靠方法。

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