颈项透明层厚度及血清标志物与病理妊娠的关系

Correlations of transparent layer thickness and serum serological markers with pathological pregnancy

摘要:

目的 探讨孕早期胎儿颈项透明层厚度及孕中期血清标志物与病理妊娠的关系。方法 选择 妊娠早期行颈项透明层厚度测量和妊娠中期行唐氏筛查的孕妇5 000 例，妊娠早期孕妇测定颈项透明层厚 度，妊娠中期孕妇测定血清甲胎蛋白（AFP）、β 人绒毛膜促性腺激素（β-HCG）、游离雌三醇（uE3）水 平。结果 颈项透明层厚度异常组胎儿先天畸形、早产、妊娠期糖尿病的发生率高于颈项透明层厚度正常组 （P <0.05）；血清AFP 升高组胎儿先天畸形、早产、妊娠期糖尿病、妊娠期高血压疾病、胎膜早破的发生率 高于血清AFP 降低组和正常组（P <0.05）；血清β-HCG 升高组和降低组胎儿先天畸形的发生率高于正常 组（P <0.05），血清β-HCG 升高组早产、妊娠期糖尿病、妊娠期高血压疾病、胎膜早破的发生率高于血清 β-HCG 降低组和正常组（P <0.05）；血清uE3 降低组胎儿先天畸形、早产、妊娠期糖尿病、妊娠期高血压 疾病、胎膜早破的发生率高于正常组（P <0.05）。孕早期颈项透明层厚度与血清AFP、β-HCG、uE3 水平 相关（P <0.05）。结论 孕早期胎儿颈项透明层厚度及孕中期血清AFP、β-HCG、uE3 水平异常与病理妊 娠有关。

Abstract:

Objective To investigate the relationships of transparent layer thickness of fetal neck in early pregnancy and serum serological markers in mid-pregnancy with pathological pregnancy. Methods A total of 5,000 cases of pregnant women, who had measurement of the thickness of the transparent layer of the fetal neck in the early pregnancy and Down's screening during the second trimester, were collected. The thickness of the neck transparent layer were determined in early pregnancy. The serum levels of alpha-fetoprotein (AFP), β-human chorionic gonadotropin (β-HCG) and free estriol (uE3) of the pregnant women were measured in the second trimester. Results The incidences of congenital malformations, premature birth and gestational diabetes mellitus in the neck transparent layer thickness anomaly group were higher than those in the normal group (P < 0.05). The incidences of fetal congenital malformations, premature labor, gestational diabetes mellitus, hypertensive disorder complicating pregnancy and premature rupture of membranes in the increased serum AFP group were higher than those of the normal serum AFP group (P < 0.05). The incidences of fetal congenital malformations in the increased and decreased serum β-HCG groups were higher than those in the normal group (P < 0.05). The incidences of premature delivery, gestational diabetes mellitus, hypertensive disorder complicating pregnancy and premature rupture of membranes in the increased serum β-HCG group were higher than those in the normal group (P < 0.05). The incidences of premature fetal death, preterm birth, gestational diabetes mellitus, hypertensive disorder complicating pregnancy and premature rupture of membranes in the decreased serum uE3 group were higher than those in the normal group (P < 0.05). The thickness of the transparent layer of the fetal neck was correlated to the serum levels of AFP, β-HCG and uE3 (P < 0.05). Conclusions The thickness of the transparent layer of fetal neck in the early pregnancy and the serum levels of AFP, β-HCG and uE3 in the second trimester are related to the pathological pregnancy.