Drugan A, Greb A, Johnson M P, Krivchenia E L, Uhlmann W R, Moghissi K S, Evans M I
Department of Obstetrics/Gynecology, Hutzel Hospital/Wayne State University, Detroit, MI 48201.
Prenat Diagn. 1990 Aug;10(8):483-90. doi: 10.1002/pd.1970100802.
Parental decisions concerning the continuation of pregnancy following prenatal detection of abnormal chromosomes were evaluated for 80 patients whose diagnosis and prenatal counselling were performed in our centre. Twenty-two anomalies were diagnosed by chorionic villus sampling (CVS) and 58 by amniocentesis. The severity of the chromosome anomaly and associated ultrasound findings in the first vs. second trimester were correlated with patients' decisions. No difference was found in the likelihood of parental decisions to interrupt or continue a pregnancy between CVS and amniocentesis for either the 'severe' or the 'questionable' group of chromosome anomalies. Ninety-three per cent of patients with severe prognosis and 27 per cent with questionable prognosis opted for pregnancy termination (p less than 0.0001). The association of ultrasound anomalies and termination was highly significant (p less than 0.001). The severity of the chromosome anomaly, and, to a lesser extent, the visualization of anomalies on ultrasound were the major determinants of parental decisions to terminate the pregnancy. The diagnosis of an anomaly in the first trimester was no more likely ito lead to a termination of pregnancy than in the second trimester.
我们对在本中心进行诊断和产前咨询的80例患者进行了评估，以了解其在产前检测到染色体异常后关于继续妊娠的决定。通过绒毛取样（CVS）诊断出22例异常，通过羊膜穿刺术诊断出58例。妊娠早期与中期染色体异常的严重程度及相关超声检查结果与患者的决定相关。对于“严重”或“可疑”染色体异常组，CVS和羊膜穿刺术在父母决定终止或继续妊娠的可能性方面未发现差异。93%预后严重的患者和27%预后可疑的患者选择终止妊娠（p<0.0001）。超声异常与终止妊娠之间的关联非常显著（p<0.001）。染色体异常的严重程度以及在较小程度上超声检查中异常的可视化是父母决定终止妊娠的主要决定因素。妊娠早期诊断出异常并不比妊娠中期更有可能导致终止妊娠。
