Relationship Between High-risk Serum Screening Combine With NT In First-trimester For Down Syndrome And Adverse Pregnancy Outcomes

Down syndrome is one of the major prevention and control of birth defects in the world.It refers to the number of multiple systemic functional defects caused by the addition of a chromosome 21 in the body.In order to reduce the birth of Down's children,Down's screening has developed into one of the most common tests during pregnancy.In recent years,studies have found that Down syndrome screening not only can screen for down syndrome,but also some serological indexes associated with some adverse pregnancy outcomes.But in Down syndrome screening indicators and pregnancy outcomes of the study is less,so suggest it is necessary for us to further explore Down syndrome screening high-risk patients with the relationship between the pregnancy outcome.Objective:To investigate the clinical relevance of combination of serological screening with NT for Down syndrome in pregnant women with high risk of pregnancy outcomes.Methods:In January 2016 to December 2016,5566 cases in ganzhou people's hospital of prenatal 11¹3⁺⁶ weeks pregnant women were took the first-trimister Down's screening combining NT?nueha l translucency,NT?,at the same time using roche electrochemical luminescence immunity analyzer to maternal serum PAPP-A and?-H CG two serum markers for testing.To take the three data together with the birth of the pregnant woman,the last menstrual period,the weight,the smoking,the pregnancy,the baby's Crown-rump length?CRL?and so on,the prenatal screening software for the people of the south,with 1:270 as the cut-off value of the risky.The risk value is greater than 1:270 for the high-risk group;Risk value<1:270 for low-risk group.The preproduction age of the high-risk group and the low-risk group was divided into the AMA group as?35 years old and the age of pregnant women as<35 years old.Steps:1.After all pregnant women were screened at the First-trimester or the second-trimester,the high-risk group and AMA were recommended to be involved in prenatal diagnosis.2.All pregnant women undergo ultrasound examination of fetal system in 18²4 weeks.Ultrasonically abnormal pregnant women were advised to have an interventional prenatal diagnosis.3.Follow up on the object of study,content including:follow-up results of prenatal diagnosis and pregnancy complications,neonatal birth usually?presence of deformity,weight,and Apgar score?,after the birth of physical and mental development.Follow-up was based on case follow-up and telephone follow-up.Results:1.Serum Screening combine with NT in first-trimester for Down Syndrome:312cases were screened as high risk.4605 cases were screened as low risk.2.Prenatal diagnosis:14 cases were diagnosised as DS in the high-risk group,1cases was missed in the low-risk group.The detection rate of DS about Serum Screening combine with NT in first-trimester was 93.33%?14/15??2 cases of DS were missed in the high-risk group because of pregnant women.The accident of DS in high-risk group was 5.12%?16/312?,was above the accident of low-risk group0.02%?1/4605??P<0.001??3.Genetic sonography at 18²4 weeks:There were 36 cases of sonographically structural abnormality in the high-risk group.There were 32 cases sonographically structural abnormality in the low-risk group.The high-risk group with abnormal fetal structure was 4.80%?15/312?higher than the low-risk group 0.39%?18/4605??P<0.05?.It has statistical mean.The high risk group of the soft index abnormal rate was 6.73%?21/312?higher than the low-risk group 0.33%?15/4605??P<0.05?,It has statistical mean.The high risk group of chromosome abnormality was 11.11%?4/36?higher than the low-risk group 3.12%?1/32?.?P=0.36,Fisher exact probability method?,no statistical significance.4.Pregnancy outcomes:There were 87 cases of adverse pregnancy outcome in the high-risk group,and the incidence of adverse pregnancy was 27.88%?87/312?.There were 489 cases of adverse pregnancy outcome in low-risk group and 10.62%of adverse pregnancy outcomes?489/4605?.The high risk group was significantly higher than the low-risk group?P<0.05?,It has statistical mean.And the incidence of abortion,fetal death,placental abruption,neonatal asphyxia,preterm birth,SGA in high-risk group were higher than the incidence of the low-risk group,and the difference was statistically significant?P<0.05?.5.In the high-risk group,112 cases of 182 women with AMA accepted prenatal diagnosis;the percentage of fetal chromosome abnormalities was 9.89%?18/182?;In the low-risk group,123 cases of 650 women with AMA accepted prenatal diagnosis;the percentage of fetal chromosome abnormalities was0.15%?1/650?;The percentage of fetal chromosome abnormalities in high-risk group was higher than the percent of in low-risk group?P<0.05?,Fisher exact probability method).Conclusion:1.DS could be detected by high-risk serum screening combined with NT at first-trimister,with the detection rate of 93.33%,and other chromosomal abnormalities.2.Among the cases with high-risk serum screening combined with NT for DS,the incidence of adverse pregnancy outcomes was high.3.The first-trimester maternal serum screening combined with NT thicken tests could be applied in pregnant women in AMA.