| Objective: To explore the clinical significance of prenatal screening of three serious congenital defect diseases-Down's syndrome(DS), Edwards syndrome(ES), and open spina bifida(OSB) during the second trimester of pregnancy and the relationships with maternal age, body weight, and gestational week, expound the significance of prenatal screening in prediction of pregnancy outcome and individualized psychological intervention with the result of screening high-risk pregnant women.Methods: Screening from January 2013 to December 2014 to Changyi County MCH voluntary prenatal screening and meet the conditions of second trimester pregnant women in 8347 cases, with automatic chemical luminescence analyzer in the detection of maternal serum alpha fetal protein(AFP) and free human chorionic gonadotropin beta subunits(Free ?-h CH) and uncojugated estriol(?E3) level; combining with maternal age, body weight, and gestational week, risk assessment software was used to calculate the risk probabilities of three kinds of fetal diseases; the high-risk pregnant women were randomly divided into experimental group and control group, both of which were recommended for further diagnosis; at the same time, the experimental group was given individual comprehensive psychological intervention, and two groups of high-risk pregnant women with pregnancy outcome and delivery situation were followed up.Results: 1. Overall screening resultsAmong 8347 pregnant women during the second trimester of pregnancy,803 high-risk pregnant women were screened out, including 685 high-risk DS pregnant women(8.20%), 37 high-risk ES pregnant women(0.44%),81 high-risk OSB pregnant women(0.97%). 616 high-risk pregnant women were followed up, the follow-up rate was 77.78%, and the compliance of further examination of high-risk pregnant women was 69.57%, 3 pregnant women was diagnosed as DS definitely and 2 pregnant women as OSB, one pregnant woman suspected of DS and one pregnant woman suspected of ES were found, the incidence rate of adverse pregnancy outcome was 4.42%.2. The relationship between high risk-rate and age, body weight and gestational week of the pregnant women in the second trimester of pregnancyThe risk rates of DS and ES were correlated with age(P<0.05),which increased with age; the risk rates of three diseases were correlated with body weight(P<0.05),risk rate of DS increased with increase of body weight, but risk rate of OSB increased with decrease of body weight,the correlation between ES and body weight was insignificant, risk rate of DS was positively correlated with gestational week(P<0.05),the risk rate increased with gestational week;risk rate of OSB was negatively correlated with gestational week(P<0.05),the risk rate decreased with gestational week.3. Effect of individualized psychological intervention on high-risk pregnant womenExperimental group of pregnant women in regular prenatal, for further check compliance, anxiety, adverse pregnancy outcomes, childbirth complications such as observation indexes are better than the control group(P<0.05).Conclusion: 1. Serological triple screening during the second trimester of pregnancy can screening out most of the high-risk pregnant women, have high clinical significance, combined with prenatal diagnosis and ultrasound examination can effectively reduce the incidence rate of birth defects infants, the risk rate of prenatal screening associated with maternal age, gestational week,and body weight, to accurately grasp the related information of pregnant women during screening, improve the accuracy of prenatal screening.2. Individual psychological intervention for high-risk pregnant women can improve the anxiety of pregnant women, establish good according to the medical behavior, in order to improve the safety of pregnancy and ensure good pregnancy outcome have positive significance. |
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