Application of ultrasound screening in early pregnancy in prenatal diagnosis of fetal chromosome abnormalities in elderly pregnant women
Objective To explore the application value of nuchal translucency(NT)ultrasound screening in the prenatal diagnosis of fetal chromosomal abnormalities in advanced pregnant women.Methods Choose 1 000 who received a prenatal diagnosis in our hospital from May 2020 to May 2021 cases of elderly pregnant women were the subjects of the study.NT screening and non-invasive DNA testing were carried out.The subjects were divided into NT thickened group(≥2.5 mm,50 cases)and NT normal group(＜2.5 mm,50 cases)according to NT thickness.950 cases),compared the detection rates of noninvasive DNA chromosomal abnormalities in the two groups of parturient,compared the differences in the detection rates of fetal chromosomal abnormalities in different pregnant women's delivery age,fetal sex,and NT thickness,and analyzed the correlation between NT thickening and the incidence of fetal chromosomal abnormalities.Logistic regression analysis was used to explore the predictive value of NT thickening on fetal chromosomal abnormalities.Results Among the 1 000 cases of parturient included in the study,50 cases had NT ≥2.5 mm,an incidence rate of 5.00％,and 50 cases of NT increased Non-invasive DNA testing in thick parturient women showed 6 cases of chromosomal abnormalities,with an abnormality rate of 12.00％.Among 950 cases of NT normal parturient,non-invasive DNA testing showed chromosomal abnormalities in only 1 case,with an abnormality rate of 0.11％.There was a significant difference between the two groups(P＜0.05).Karyotype analysis showed that the 7 cases of chromosomal abnormalities were 3 cases of trisomy 21,2 cases of abnormal chromosome number(28.57％),and 2 cases of trisomy 18.The analysis of chromosome abnormality rate showed that the detection rate of fetal chromosome abnormality in 35 years pregnant women was higher than that of 30～34 years,the detection rate of female fetuses was higher than that of male fetuses,and the detection rate of NT thickness of 5.5 mm was higher than that of 2.5～＜3.5 mm and 3.5～＜4.5 mm(P＜0.05).Trend chi-square correlation analysis showed that NT thickness was significantly positively correlated with the incidence of fetal chromosomal abnormalities(P＜0.05).The AUC value(95％CI)for diagnosing fetal chromosomal abnormalities with NT thickening is 0.631(0.545,0.718),P=0.004.Logistic regression analysis showed that NT thickening was an independent risk factor for fetal chromosomal abnormalities(P＜0.05).Conclusion Early ultrasonographic NT detection can be used as an important screening index for fetal chromosomal non-invasive DNA detection for older parturients,and the risk of chromosomal abnormalities in fetuses with thickened NT is significantly increased.
NT ultrasound screeningElderly pregnant womenPrenatal diagnosisChromosome aberrations
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维普
