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在神经管缺损(NTD)低危人群中,血清甲胎蛋白(MSAFP)作为筛查试验,其目的是找出某些孕妇尚需进一步作较昂贵或具有危险性的诊断检查。在首次发现MSAFP升高后,一般可根据孕周和MSAFP升高的程度,重复测定MSAFP一次。对胎龄较大(大于18孕周),或MSAFP值较高(大于3倍中位数)的孕妇,一般不建议作MSAFP复测,对这些病例,或第二次MSAFP测值仍然增高的孕妇,如尚未作过超声检查,则建议先超声检查,以确定孕周、胎儿数目、存活情况及胎儿有无大体畸形(图1)。如超声检查后,仍未能确定MSAFP升高的原因,可考虑进一步作定标扫描(targeted scan,即以超声详细地检查胎儿解剖结构上的异常),或羊膜腔穿刺术检查,或者这二项检查同时进行。目前在许多医疗中心,定标扫描已当作羊膜腔穿刺术前的常规检查。当今超声的分辨能力确实已有很大的提高,因此
Serum alpha-fetoprotein (MSAFP) is used as a screening test in low-risk populations of neural tube defects (NTDs) in order to identify some pregnant women that require more expensive or dangerous diagnostic tests. MSAFP was first detected after the increase, according to the general gestational age and MSAFP increased level of repeated determination of MSAFP once. Pregnant women with a larger gestational age (> 18 weeks old) or with higher MSAFP (> 3 -fold median) are generally not recommended for MSAFP retest, and these or the second MSAFP measurements are still elevated Pregnant women, if not yet made ultrasound examination, it is recommended to first ultrasound to determine the gestational age, the number of fetuses, survival and fetal gross deformity (Figure 1). After echocardiography, the reason for the elevated MSAFP has not yet been determined and may be considered for further targeted scans (ie, ultrasonography to examine fetal anatomy abnormalities in detail), or amniocentesis, or both Check items at the same time. At many medical centers, scans have been routinely performed prior to amniocentesis. Today’s resolution of ultrasound has indeed been greatly improved, so