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超声联合无创产前检测在产前检测中的应用

Application of ultrasound combined with noninvasive prenatal testing in prenatal testing.

作者信息

Liu Ci, Zhou Yingjie, Liu Peng, Geng Yue, Zhang Heng, Dun Yajing, Zhen Menglei, Zhao Zhiyu, Zhu Mingju, Huang Qingzhi, Liu Ruicen, Wang Xiuli

机构信息

Seven Section of Department of Gynaecology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.

Department of Gynecology, Zhengding Maternal and Child Health Hospital, Zhengding, China.

出版信息

Transl Pediatr. 2022 Jan;11(1):85-98. doi: 10.21037/tp-21-617.

Abstract

BACKGROUND

Both noninvasive prenatal testing (NIPT) and prenatal ultrasound are widely used in clinical settings due to their safety, noninvasiveness, and accuracy, showing high detection rates for fetal chromosomal aneuploidies and structural abnormalities. However, whether the combined application of these two techniques has higher clinical applicability remains to be demonstrated.

METHODS

The clinical and laboratory data of 3,050 pregnant women who underwent NIPT were collected. The clinical feasibility and health economics of NIPT were investigated by analyzing the accuracy, postnatal follow-up results, and population applicability of NIPT. In addition, an analysis ultrasonography, NIPT, and karyotyping results were performed to evaluate the combined application of ultrasonography and NIPT in screening fetal chromosomal abnormalities.

RESULTS

NIPT could accurately detect trisomies 21, 18, and 13, and was highly sensitive and specific in detecting other autosomal and sex chromosomal aneuploidies. The positive rates of chromosomal abnormalities in the presence of 1 or 2 or more ultrasound markers were 7.5% and 29.2%, respectively, indicating that ultrasonography combined with NIPT should be preferred for the detection of fetal chromosomal abnormalities.

CONCLUSIONS

Health economic analysis revealed NIPT to be superior to conventional serologic screening in terms of accuracy and socioeconomics. Ultrasound and NIPT are complementary to each other and the combined techniques can improve the screening ability of fetal chromosomal abnormalities and provide clinicians with more diagnostic information.

摘要

背景

无创产前检测(NIPT)和产前超声检查因其安全性、无创性和准确性,在临床环境中被广泛应用,对胎儿染色体非整倍体和结构异常显示出较高的检出率。然而,这两种技术的联合应用是否具有更高的临床适用性仍有待证实。

方法

收集3050例接受NIPT的孕妇的临床和实验室数据。通过分析NIPT的准确性、产后随访结果和人群适用性,研究NIPT的临床可行性和健康经济学。此外,对超声检查、NIPT和核型分析结果进行分析,以评估超声检查和NIPT在筛查胎儿染色体异常中的联合应用。

结果

NIPT能够准确检测21、18和13三体,在检测其他常染色体和性染色体非整倍体方面具有高度敏感性和特异性。存在1个或2个或更多超声标志物时染色体异常的阳性率分别为7.5%和29.2%,表明超声检查联合NIPT在检测胎儿染色体异常方面应优先选择。

结论

健康经济学分析显示,NIPT在准确性和社会经济学方面优于传统血清学筛查。超声检查和NIPT相互补充,联合技术可以提高胎儿染色体异常的筛查能力,并为临床医生提供更多诊断信息。

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