【摘要】 目的 了解21-三体综合征和致死性大畸形的诊断情况,提出降低围产儿21-三体综合征和致死性大畸形发生率的有效措施。方法 对上海市杨浦区1990年7月～2000年6月围产期21-三体和大畸形的病例资料进行回顾性分析。结果 ①10a间围产儿共计58965例,死亡551例,围产儿死亡率9.35‰。②大畸形43例,21-三体综合征37例,计80例,发生率1.36‰。死亡48例,占围产儿死亡的8.7％。③外来人口接受产前检查率为25％,显著低于本市人口的84.4％,两者比较,差异有非常显著性(P<0.001)。④外来人口围产儿21-三体综合征和大畸形发生率为2.52‰,显著高于本市人口的1.22‰,两者比较,差异有非常显著性(P<0.01)。⑤接受产前检查的大畸形,在孕28周之前确诊率为12％,孕28周之后确诊率为64％,未确认为24％。结论 增强孕妇产前保健意识,提高产前诊断质量,提高21-三体综合征和致死性大畸形在孕28周之前确诊率,并进行治疗性流产,可降低围产期21-三体综合征和致死性大畸形发生率,进一步降低围产儿死亡率。更多还原

【Abstract】 [Objective] To analyze the diagnosis of trisomy syndrome and malformation. Put forward effective measure to reduce the incidence of prenatal trisomy syndrome and malformation. [Methods] A retrospective study on prenatal trisomy syndrome and malformation from 1990 to 2000 was carried out. [Results] During the 10 years, among 58965 prenatal cases, 551 died, death rate is 9.35% . Among the 80 cases, 43 of them were malformation, 37 were trisomy syndrome, and incidence rate was 1.36 % 0. 48 cases died which was 8.7% of the prenatal. 25 % of those who received prenatal care were outside - coming population, which was significantly lower than that of the native population (84.4%, P < 0.001). Prenatal trisomy syndrome and malformation incidence was 2.52% in outside - coming population, which was significantly higher than that of 1.22% in native population ( P < 0.01) . Among those who accepted prenatal care, the malformation diagnosed within 28 weeks was 12% , 64% of those over 28 weeks. [Conclusion] Gravidas should have consciousness in prenatal health protection. The quality of prenatal diagnose should be upgraded. Diagnose of trisomy syndrome and malformation before 28 weeks should be improved. Abortion should be carried out for treatment, incidence on prenatal trisomy syndrome and malformation should be reduced, and so does prenatal mortality.更多还原