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目的分析多胎妊娠的介入性产前诊断方法的选择及胎儿染色体异常情况。方法选取该院2011年1月-2014年12月32例多胎妊娠病例为研究对象,分析其介入性产前诊断方法的选择及胎儿染色体异常情况。结果 32例多胎妊娠(66例胎儿),其中65个胎儿行产前诊断染色体核型分析。32例多胎妊娠包括单绒毛膜双羊膜囊(Monochorionic diamniotic,MCDA)双胎12例、单绒毛膜三羊膜囊(Monochorionic triamniotic,MCTA)三胎1例、双绒毛膜双羊膜囊(Dichorionic diamniotic,DCDA)双胎18例、三绒毛膜三羊膜囊(Trichorionic triamniotic,TCTA)三胎1例,根据孕周及绒毛膜性质为每个胎儿选择不同的介入性产前诊断。其中,1例(8.33%,1/12)MCDA双胎之一染色体异常(46,XY和45,X),2例(11.76%,2/17)DCDA双胎之一染色体异常(46,XY和45,X;46,XY和47,XY,+18),其余胎儿核型正常。结论胎儿超声检出异常的多胎妊娠应根据绒毛膜性质的不同,选择适合的介入性产前诊断方法,为每例胎儿分别取样行染色体核型分析。对于MCDA双胎,双胎羊水染色体核型分析相对于绒毛或脐血染色体核型分析而言,能更好地反映各个胎儿的染色体核型。
Objective To analyze the choice of interventional prenatal diagnosis of multiple pregnancy and fetal chromosomal abnormalities. Methods Thirty-two cases of multiple pregnancy from January 2011 to December 2014 in our hospital were selected as research objects. The methods of interventional prenatal diagnosis and chromosomal abnormalities were analyzed. Results 32 cases of multiple pregnancy (66 fetuses), of which 65 fetuses were diagnosed prenatal chromosome karyotype analysis. Thirty-two cases of multiple pregnancy included 12 cases of twins of Monochorionic diamniotic (MCDA), 1 case of 3 cases of monochorionic triamniotic (MCTA), 3 cases of Dichorionic diamniotic (DCDA) ) Twins and one case of three trigeminal triamnion (TCTA) fetuses. According to gestational age and chorionic property, we chose different interventional prenatal diagnosis for each fetus. Chromosomal abnormalities (46, XY and 45, X) and 2 (11.76%, 2/17) DCDA twins were found in one case of MCDA twins (8.33%, 1/12) And 45, X; 46, XY and 47, XY, + 18), the rest of the fetus normal karyotype. Conclusion Fetal ultrasound abnormalities in multiple pregnancies should be based on the different chorion properties, select the appropriate interventional prenatal diagnosis method for each fetus were sampled line karyotype analysis. For MCDA twins, the twin amniotic fluid karyotype analysis better reflects the karyotype of each fetus relative to the karyotype analysis of villus or cord blood.