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韩国母胎医学会产前非整倍体筛查和诊断检测临床实践指南:(1)产前非整倍体筛查。

Clinical Practice Guidelines for Prenatal Aneuploidy Screening and Diagnostic Testing from Korean Society of Maternal-Fetal Medicine: (1) Prenatal Aneuploidy Screening.

机构信息

Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.

Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.

出版信息

J Korean Med Sci. 2021 Jan 25;36(4):e27. doi: 10.3346/jkms.2021.36.e27.

Abstract

In 2019, the Korean Society of Maternal-Fetal Medicine developed the first Korean clinical practice guidelines for prenatal aneuploidy screening and diagnostic testing. These guidelines were developed by adapting established clinical practice guidelines in other countries that were searched systematically, and the guidelines aim to assist in decision making of healthcare providers providing prenatal care and to be used as a source for education and communication with pregnant women in Korea. This article delineates clinical practice guidelines specifically for maternal serum screening for fetal aneuploidy and cell-free DNA (cfDNA) screening. A total of 19 key questions (12 for maternal serum and 7 for cfDNA screening) were defined. The main recommendations are: 1) Pregnant women should be informed of common fetal aneuploidy that can be detected, risks for chromosomal abnormality according to the maternal age, detection rate and false positive rate for common fetal aneuploidy with each screening test, limitations, as well as the benefits and risks of invasive diagnostic testing, 2) It is ideal to give counseling about prenatal aneuploidy screening and diagnostic testing at the first prenatal visit, and counseling is recommended to be given early in pregnancy, 3) All pregnant women should be informed about maternal serum screening regardless of their age, 4) cfDNA screening can be used for the screening of trisomy 21, 18, 13 and sex-chromosome aneuploidy. It is not recommended for the screening of microdeletion, 5) The optimal timing of cfDNA screening is 10 weeks of gestation and beyond, and 6) cfDNA screening is not recommended for women with multiple gestations. The guideline was reviewed and approved by the Korean Academy of Medical Sciences.

摘要

2019 年,韩国母胎医学会制定了首份韩国产前非整倍体筛查和诊断检测临床实践指南。该指南通过系统搜索其他国家已确立的临床实践指南改编而来,旨在为提供产前保健的医疗保健提供者的决策提供帮助,并作为与韩国孕妇进行教育和沟通的资源。本文详细阐述了母体血清胎儿非整倍体筛查和游离 DNA(cfDNA)筛查的临床实践指南。共定义了 19 个关键问题(母体血清筛查 12 个,cfDNA 筛查 7 个)。主要建议如下:1. 应告知孕妇常见的可检测胎儿非整倍体、根据母体年龄的染色体异常风险、每种筛查试验检测常见胎儿非整倍体的检出率和假阳性率、局限性以及侵入性诊断检测的获益和风险;2. 最好在第一次产前检查时进行产前非整倍体筛查和诊断检测咨询,建议在妊娠早期进行咨询;3. 无论年龄大小,所有孕妇均应接受母体血清筛查;4. cfDNA 筛查可用于筛查 21、18、13 三体和性染色体非整倍体。不建议用于筛查微缺失;5. cfDNA 筛查的最佳时间是 10 孕周及以后;6. cfDNA 筛查不建议用于多胎妊娠的孕妇。该指南经韩国医学科学院审查和批准。

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