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产前筛查与无创基因测序在胎儿出生缺陷中的应用价值

Application values of prenatal screening and non-invasive gene sequencing in fetal birth defects.

作者信息

Bu Jingjing, Jiang Pan, Cui Xiaoli, Zhou Hongyan, Han Fengxia

机构信息

Jingjing Bu Central laboratory, Binzhou People's Hospital, Shandong, 256600, China.

Pan Jiang Central laboratory, Binzhou People's Hospital, Shandong, 256600, China.

出版信息

Pak J Med Sci. 2020 Nov-Dec;36(7):1545-1549. doi: 10.12669/pjms.36.7.2290.

Abstract

OBJECTIVE

To investigate effects of prenatal screening and non-invasive gene sequencing on the clinical diagnosis of fetal birth defects and the outcome of pregnancy.

METHODS

Totally 2520 pregnant women who received prenatal screening in our hospital were selected as the research subjects. The high-risk pregnant women were further tested by the non-invasive gene sequencing technology. Pregnant women with positive results were diagnosed by amniocentesis and fetal chromosome karyotype analysis, and the pregnancy outcome was followed up for one year.

RESULTS

870 out of the 2520 pregnant women was tested by non-invasive gene sequencing technology; 26 of the 870 women was 13-trisomy-positive and was diagnosed by amniocentesis and fetal chromosome karyotype analysis, 22 of which was diagnosed as 47, XN, +13 and four of which was normal; the diagnosis accuracy of non-invasive prenatal testing (NIPT) was 84.6%. 18 out of the 22 confirmed cases underwent abortion, three cases had termination of embryonic development, and one case had postnatal anomaly. Thirty four out of the 2520 pregnant women was 18-trisomy-positive and was diagnosed by amniocentesis and fetal chromosome karyotype analysis, 31 of which was diagnosed as 47, XN, +18 and three cases were normal; the diagnosis accuracy of NIPT was 91.2%. 29 out of the 31 confirmed cases underwent abortion and two cases had termination of embryonic development. Forty out of the 2520 pregnant women was 21-trisomy-positive and was diagnosed by amniocentesis and fetal chromosome karyotype analysis, 39 of which was diagnosed as 47, XN, +21 and one case was normal; the diagnosis accuracy of NIPT was 97.5%. Thirty four out of the 39 confirmed cases underwent abortion, three cases had termination of embryonic development, and two cases had postnatal anomaly. Twenty eight cases were tested as sex chromosome-positive and were diagnosed by amniocentesis and fetal chromosome karyotype analysis, 25 out of which was diagnosed as abnormal and three cases were normal; the diagnosis accuracy of NIPT was 89.3%. 24 out of the 25 confirmed cases underwent abortion, and one case had termination of embryonic development.

CONCLUSION

Prenatal screening and non-invasive gene sequencing technology have a high accuracy in the diagnosis of fetal birth defects, which can reduce the maternal abortion injury as much as possible and relieve the psychological pressure. The promotion of the mode can be strengthened in clinics.

摘要

目的

探讨产前筛查及无创基因测序对胎儿出生缺陷临床诊断及妊娠结局的影响。

方法

选取在我院接受产前筛查的2520例孕妇作为研究对象。对高危孕妇进一步采用无创基因测序技术检测。结果阳性的孕妇通过羊水穿刺及胎儿染色体核型分析进行诊断,并对妊娠结局进行1年随访。

结果

2520例孕妇中870例接受无创基因测序技术检测;870例中26例13-三体阳性,经羊水穿刺及胎儿染色体核型分析确诊,其中22例诊断为47,XN,+13,4例正常;无创产前检测(NIPT)诊断准确率为84.6%。22例确诊病例中18例流产,3例胚胎停育,1例出生后异常。2520例孕妇中34例18-三体阳性,经羊水穿刺及胎儿染色体核型分析确诊,其中31例诊断为47,XN,+18,3例正常;NIPT诊断准确率为91.2%。31例确诊病例中29例流产,2例胚胎停育。2520例孕妇中40例21-三体阳性,经羊水穿刺及胎儿染色体核型分析确诊,其中39例诊断为47,XN,+21,1例正常;NIPT诊断准确率为97.5%。39例确诊病例中34例流产,3例胚胎停育,2例出生后异常。28例性染色体阳性,经羊水穿刺及胎儿染色体核型分析确诊,其中25例诊断为异常,3例正常;NIPT诊断准确率为89.3%。25例确诊病例中24例流产,1例胚胎停育。

结论

产前筛查及无创基因测序技术对胎儿出生缺陷诊断准确率高,可最大程度减少母体流产损伤,缓解心理压力。临床上可加强该模式的推广。

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