Akinbiyi A A
Oldham and District General Hospital, UK.
Int J Gynaecol Obstet. 1996 Apr;53(1):17-21.
The aim of the study was to evaluate the significance of unexplained elevated maternal serum alpha-fetoprotein in singleton pregnancies as a predictor of fetal risk.
A retrospective study of 1582 consecutive women who attended the antenatal clinic at Oldham and District General Hospital, Oldham, UK, over a 6-month period. One hundred pregnant women with elevated serum alpha-fetoprotein concentrations were classified as the index group and were matched against a control group. All the women in the index group underwent amniocentesis and detailed ultrasonography. The incidence of antepartum hemorrhage (placental abruption and placenta previa), preterm labor and intrauterine growth restriction (IUGR) in the two groups was analyzed and the results subjected to X2 analysis.
None of the patients in the index group had chromosomal abnormalities or birth defects. IUGR occurred in 18 (18%) of the index group babies but in only four (2%) in the control group (P < 0.0000006). Placental abruption occurred in five (5%) in the index group compared with two (2%) in the control group (P < 0.03), while preterm labor occurred in nine (9%) in the index group compared with two (2%) in the control group (P < 0.005).
Women with unexplained elevated maternal serum alpha-fetoprotein are at increased risk of preterm labor, antepartum hemorrhage (placental abruption) and IUGR.
本研究旨在评估单胎妊娠中原因不明的母体血清甲胎蛋白升高作为胎儿风险预测指标的意义。
对英国奥尔德姆奥尔德姆区综合医院产前门诊连续6个月就诊的1582名妇女进行回顾性研究。将100名血清甲胎蛋白浓度升高的孕妇分为指数组，并与对照组进行匹配。指数组所有妇女均接受了羊膜穿刺术和详细的超声检查。分析两组产前出血（胎盘早剥和前置胎盘）、早产和宫内生长受限（IUGR）的发生率，并对结果进行X²分析。
指数组患者均无染色体异常或出生缺陷。指数组18名（18%）婴儿发生IUGR，而对照组仅4名（2%）（P<0.0000006）。指数组5名（5%）发生胎盘早剥，对照组2名（2%）（P<0.03），指数组9名（9%）发生早产，对照组2名（2%）（P<0.005）。
原因不明的母体血清甲胎蛋白升高的妇女发生早产、产前出血（胎盘早剥）和IUGR的风险增加。
