目的 探讨细菌人工染色体标记—微球鉴别(BoBs)技术在染色体异常产前诊断中的价值及适用人群,为临床诊断提供参考依据.方法 对122例因无创产前筛查(NIPT)高风险、产前血清学筛查高风险或35岁以上高龄就诊的单胎孕妇取绒毛或羊水,同时进行BoBs检测和染色体核型分析.结果 除去1例羊水标本培养失败未进行核型分析,其余标本BoBs结果均与核型分析结果一致.在43例NIPT筛查高风险、47例血清学筛查高风险及32例高龄妊娠孕妇标本中确诊例数依次为27例、1例和0例;此28例染色体异常标本包括21-三体18例、18-三体6例和XXY 4例;其中1例21-三体为嵌合型,核型分析结果为47,XN,+21,der (21;21) (q10;q10) [13] /46,XN[25].此外,BoBs技术还能检测9种常见微缺失综合征,但在本次检测未遇到阳性样本.结论 BoBs技术可为染色体分析提供快速、准确、高通量的产前诊断,还可作为传统核型分析细胞培养失败等特殊情况的补救措施,尤其适用于NIPT筛查高风险需进一步快速确诊的孕妇以及有微缺失综合征高危表征的孕妇;而血清学筛查高风险及高龄妊娠孕妇,从技术应用的阳性检出率和成本考虑,则不建议作为首选群体.

目的 观察产前检查在妊娠晚期胎盘早剥诊断中的临床效果.方法 100例妊娠晚期孕妇,均进行产前检查,随访3个月记录最终结果 并依此为金标准,观察产前检查及随访的最终胎盘早剥情况,并比较差异,计算产前检查胎盘早剥诊断准确率.结果100例孕妇经产前检查发现,有15例孕妇为胎盘早剥;随访3个月最终发现,有17例孕妇为胎盘早剥;产前检查与最终发现胎盘早剥情况比较差异无统计学意义(P>0.05).产前检查胎盘早剥诊断准确率为88.2％(15/17).结论 产前检查在妊娠晚期胎盘早剥诊断中应用价值较高,其可尽早发现、尽早诊治胎盘早剥现象,有效保障母婴安全,临床应用价值较高,值得临床推广.

Objective To investigate the application value of inducing abortion by water bag in the middle and late stage of uterine scar pregnancy .Methods 224 cases of patients underwent inducing abortion by water bag in Longgang Women and Children Health Care Hospital from January 2013 to May 2017 were selected as the research objects .They were divided into the observation group(96 cases with uterine scar ) and the control group (128 cases without uterine scar ) according to whether or not with uterine scar . The induction of labor and safety of the two groups were analyzed .Results There were no significant differences in the time of induction of labor ,the length of hospital stay and the amount of postpartum hemorrhage of 24 hours between the observation group and the control group(P>0.05).The success rate, the rate of postpartum uterine curettage and soft birth canal damage in the observation group were 97.92 ％, 14.58％and 4.17％respectively , and compared with 98.44％, 12.50％and 6.25％in the control group , the differences were not statistically significant ( P >0.05 ) .There was no significant difference in incidence of complications of induction of labor between the observation group and the control group (P>0.05).Conclusion It is feasible to use the water bag induced abortion in the middle and late stage of pregnancy with scar uterus , which does not affect the success rate of induced labor , nor increase the risk of complications of induction of labor .This method is worthy of clinical promotion .

Objective To analyze the effects of the new labour standard on the delivery process and the prognoses of women with full-term pregnancy and fetuses.Methods A total of 153 women with full-term pregnancy were randomly divided into study group (79 cases) and control group (74 cases).Labour process of the study group were analyzed and dealt according to new labour standard;while labour process in control group were analyzed and dealt according to the old labour standard.The vaginal spontaneous delivery rate,cesarean section rate,vaginal delivery rate,labour intervention and the prognosis of pregnant women and fetuses were compared and studied between the two groups.Results The cesarean section rate of study group (13.9％) was lower than that of control group (29.7％),and vaginal delivery rate in study group (81.0％) were significantly higher than that in control group (67.6％),and differences were both significant (both P ＜ 0.05).Rate of labour interventions in study group (30.4％)was lower than that in control group (52.7％),P ＜0.05.The prognoses of pregnant women and fetuses in study group were better than those in control group;the overall incidences of bad prognoses of women and fetuses in study group were lower that those in control group,the differences were significant (all P ＜ 0.05).Conclusions The new labour standard can reduce the rate of cesarean section and the labour intervention for women with full-term pregnancy;and it also can improve the prognoses of the pregnant women and the fetuses,which is suitable for clinical application.

Objective To explore the clinical value of non-invasive prenatal gene detection in prenatal screening for fetal chromosome aneuploidy. Methods 900 single pregnant women who were tested for noninvasive prenatal gene in our hospital from January 2017 to March 2018 were selected as the subjects. The peripheral venous blood of pregnant women was collected and DNA was free, and the high flux was sequenced. High risk parturients were examined by amniotic cavity or umbilical vein puncture and karyotype detection. Results Among 900 single pregnant women, 11 cases were detected with high risk by testing peripheral blood, and the positive rate was 1. 22％. Among them, 7 cases were 21-trisomy syndrome, 1 case was 13-trisomy syndrome, and 3 cases were18-trisomy syndrome. The chromosomal karyotype analysis of 11 high-risk pregnant women screened by noninvasive prenatal gene detection showed that the coincidence rate of noninvasive prenatal gene detection and chromosome karyotype analysis was 100％. High risk pregnant women had the followingindicators of noninvasive detection: elder age, NT thickening, Down syndrome. The karyotype of 21-trisomy syndrome was (47, XN, + 21), the chromosome karyotype of 13-trisomy syndrome was (47, XXX), the karyotype of 18-trisomy syndrome was (47, XN, + 18). All of the pregnant women with high risk terminated pregnancy. Conclusion Noninvasive prenatal gene detection has higher diagnostic accuracy for fetal chromosomal aneuploidy. It has the advantages of noninvasive, high sensitivity and high safety. Early screening for fetal defects has worthy of clinical value.

目的:探讨对瘢痕子宫患者经阴道分娩加强产程管理的临床效果.方法:研究选择本院于2015年12月至2018年1月期间收治的300例瘢痕子宫阴道分娩产妇作为资料,随机分组各150例,对照组为常规产程监护,观察组加强产程管理,比较产程时间、出血量及住院时间等.结果:观察组产程、出血量、住院时间均显著低于对照组,P<0.05;两组分娩安全性无明显差异,P>0.05.结论:针对瘢痕子宫阴道分娩产妇加强产程管理可缩短产程时间,减少出血量及预防并发症发生,临床应用价值较高.

目的 探究孕妇产前行无创性染色体非整倍体基因检测的临床价值.方法 选取2016.1-2017.2期间入我院行产前检查的934名孕妇为本次研究对象,所有孕妇入院后取外周血,行无创性胎儿染色体非整倍体基因检查,并就结果对检测为高风险孕妇行羊水穿刺,对高风险孕妇进行染色体核型分析,判断胎儿基因是否出现问题,以羊水穿刺、染色体核型分析结果为金标准,观察无创性染色体非整倍体基因检测用于产前胎儿非整倍体基本诊断的准确性.结果 934名孕妇无创性产前基因检查共有10例为高风险,阳性率1.07％,其中13-三体综合征2例、21-三体综合征6例、18-三体综合征2例,高风险孕妇羊水穿刺染色体核型分析,结果13-三体综合征2例、21-三体综合征6例、18-三体综合征2例,本次胎儿染色体疾病(1 3-三体综合征2例、21-三体综合征6例、18-三体综合征2例)无创性产前基因检测检查准确率100％,基因检查低风险者胎儿随访至出生,未发现染色体疾病.结论 无创产前基因检测对胎儿染色体非整倍体疾病诊断具有良好准确性,临床用于胎儿排畸筛查有重大意义,能有效减少畸形胎儿出生.