Abstract：Objective: To observe the screening effect of the first trimester serum PAPP-A combined with the second trimester serum AFP for Down's syndrome. Methods: A retrospective analysis was made of 1300 pregnant women who underwent prenatal screening and were followed up in the obstetric clinic of our hospital. This study is divided into two programs. First trimester program: Serum PAPP-A and AFP levels were measured during first trimester (10~13+6 weeks). Combined program: Serum PAPP-A levels were measured during first trimester (10~13+6 weeks), and AFP levels were measured during second trimester (15-20+6 weeks).Prenatal screening software Muldeale was used to estimate the risk of Down's syndrome in combination with the age, gestational age, weight, pregnancy history and previous medical history of pregnant women.The high-risk cutoff value of DS is 1/270, and more than 1/270 is high-risk. The screened high-risk pregnant women were given genetic counseling, and the fetal chromosome karyotype was analyzed by diagnostic amniocentesis. The abnormal fetus is selected by the pregnant woman and their family to choose therapeutic abortion. Calculate the positive rate and false positive rate of DS screening for both programs. . Results: The combined program screened 41 high-risk and 81 critical-risk DS patients. In the first trimester program,63 high-risk and 109 critical -risk DS patients were identified. The high risk, critical-risk of DS and total positive rate of screening results of combined program were lower than those of the first trimester program (P < 0.05).6 cases were diagnosed as DS by chromosome karyotype analysis of amniocentesis.5 cases of DS positive in the combined program,the positive rate was 83.3%. 3 cases of DS positive in the first trimester program,the positive rate was 50%. Compared with the two programs, the combined program is better than the first trimester program. Conclusion: The detection of serum PAPP-A in the first trimester combined with serum AFP in the second trimester has a definite effect for Down's syndrome screening. It is worthy of clinical application.
付久园, 肖艳平, 朱艳菊, 张金环. 早孕期血清PAPP-A检测联合中孕期血清AFP检测对唐氏综合征筛查效果的研究[J]. 河北医学, 2019, 25(5): 776-778.
FU Jiuyuan, XIAO Yanping, ZHU Yanju, et al. Screening Efficiency about the First Trimester Screening of PAPP-A Combined with the Second Trimester Screening of AFP for Down's Syndrome. HeBei Med, 2019, 25(5): 776-778.
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2019, Vol. 25 
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