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孕早期低风险无创产前检测孕妇的母血清生化指标及胎儿超声扫描评估

Assessment of Maternal Serum Biochemical Attributes and Fetal Ultrasound Scans in First-Trimester Low-Risk Noninvasive Prenatal-Tested Pregnant Women.

作者信息

Keshari J R, Kumar Uday, Kumar Prabhat, Prasad Dipali, Prakash Pritam, P Pushpanjali

机构信息

Biochemistry, Indira Gandhi Institute of Medical Sciences, Patna, IND.

Pathology, Indira Gandhi Institute of Medical Sciences, Patna, IND.

出版信息

Cureus. 2022 May 1;14(5):e24653. doi: 10.7759/cureus.24653. eCollection 2022 May.

Abstract

INTRODUCTION

The first trimester of pregnancy is marked by several important disrupting changes as a result of complex biological upshot of events required for the development of the fetus. These changes in the biological events result in changes in the maternal serum biomarkers that are associated with fetal growth. The aim of the present study was to evaluate the correlation between the maternal blood biochemical determinants such as pregnancy-associated plasma protein-A (PAPP-A) and alpha fetoprotein (AFP) with ultrasound scans during early pregnancy in the first trimester.

METHODS

The study included 139 women whose fetus was alive between 11±1 weeks of gestation. The risk of fetal chromosomal abnormalities at first trimester was analyzed by the VeriSeq NIPT Solution v2 platform (Illumina, San Diego, CA, USA) for noninvasive prenatal testing (NIPT) assay. The PAPP-A and AFP levels were evaluated by chemiluminescent immunoassays. The levels of PAPP-A and AFP were correlated with the fetal heart rate (HR), crown rump length (CRL), and nuchal translucency (NT) by Pearson's correlation analysis.

RESULTS

The mean age of the participants was 28.35±3.87 years (minimum=21, maximum=35). The mean AFP and PAPP-A levels in the maternal plasma were 14.76±1.04 ng/mL and 4.37±0.86 mIU/ml respectively. The mean FHR, CRL, and NT were 138±7.62 bpm, 59±3.24 mm, and 2.3±0.61 mm respectively. PAPP-A and AFP significantly (p<0.05) correlated with fetal HR, CRL, and NT at 11±1 weeks of gestation. The mean ratio of AFP:PAPP-A in low-risk pregnancies was 3.37.

CONCLUSIONS

The maternal serum biochemical attributes correlated well with the fetal ultrasound scans. The findings of the present study can prove to be clinically useful for clinical research, obstetrics, and gynaecology, especially for examinations of first-trimester pregnancies.

摘要

引言

由于胎儿发育所需事件的复杂生物学结果,妊娠早期的特点是发生了一些重要的干扰性变化。这些生物学事件的变化导致与胎儿生长相关的母体血清生物标志物发生变化。本研究的目的是评估妊娠早期(孕早期)母体血液生化指标,如妊娠相关血浆蛋白A(PAPP - A)和甲胎蛋白(AFP)与超声扫描之间的相关性。

方法

该研究纳入了139名妊娠11±1周时胎儿存活的女性。通过VeriSeq NIPT Solution v2平台(美国加利福尼亚州圣地亚哥的Illumina公司)进行非侵入性产前检测(NIPT)分析,以评估孕早期胎儿染色体异常的风险。通过化学发光免疫测定法评估PAPP - A和AFP水平。通过Pearson相关性分析,将PAPP - A和AFP水平与胎儿心率(HR)、头臀长度(CRL)和颈部透明带(NT)进行相关性分析。

结果

参与者的平均年龄为28.35±3.87岁(最小=21岁,最大=35岁)。母体血浆中AFP和PAPP - A的平均水平分别为14.76±1.04 ng/mL和4.37±0.86 mIU/ml。平均胎心率、头臀长度和颈部透明带分别为138±7.62次/分钟、59±3.24毫米和2.3±0.61毫米。在妊娠11±1周时,PAPP - A和AFP与胎儿心率、头臀长度和颈部透明带显著相关(p<0.05)。低风险妊娠中AFP:PAPP - A的平均比值为3.37。

结论

母体血清生化指标与胎儿超声扫描结果相关性良好。本研究结果在临床研究、妇产科,尤其是孕早期检查中可能具有临床应用价值。

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