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【请教】急！！！！老婆唐氏综合征风险率高达1/13，请教计算公式和大家的分析！！
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这个帖子发布于4年零302天前，其中的信息可能已发生改变或有所发展。
体重：50KG
孕周：16周1天老婆唐氏筛查结果：AFP
27.91U/ ml
MOM值0.81Free-b-HCG
108.01ng/ml
MOM值5.72唐氏综合征风险率
1/13!!!!!18三体风险率
1/52631神经管缺陷风险
0.81母龄风险率
31.59岁 报告上的计算方法是： ByBPD请各位站友指点 今天汗都急出来了，谢谢大家！！
不知道邀请谁？试试他们
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关注！ 怎么没这方面的专业人士回答？--------------------------------------------------- Calculation of the risk of Down's syndrome The Markers First trimester markersPregnancy Associated Plasma Protein-A (PAPP-A)free ?-human chorionic gonadotrophin ( free ?-hCG)Nuchal translucency (NT)Second trimester markersAlpha-fetoprotein (AFP)unconjugated oestriol (uE3)total human chorionic gonadotrophin (hCG)Inhibin-A (inhibin)In the first trimester of pregnancy the PAPP-A level is, on average, low in Down's syndrome pregnancies (about half that of unaffected pregnancies), and the nuchal translucency measurement and free ?-hCG levels are, on average, high (about double that of unaffected pregnancies). In the second trimester AFP and uE3 levels are, on average, low (about three-quarters that of unaffected pregnancies) and inhibin and hCG levels are, on average, high (about double that of unaffected pregnancies).The concentrations of the markers vary with gestational age. In the first trimester PAPP-A and NT increase, while free ?-hCG decreases. In the second trimester AFP and uE3 increase, hCG decreases, and inhibin decreases before 17 weeks and increases after 17 weeks. Also, the measurement of serum markers may vary between laboratories. In order to take account of this variation, the concentration of each marker is expressed as a multiple of the median for unaffected pregnancies of the same gestational age (MoM).In the diagram below the median marker level is 2.5 iu/mL at 10 weeks, 5.0 iu/mL at 12 weeks and 10.0 iu/mL at 14 weeks. If a woman is found to have 5.0 iu/mL at 10 weeks her level is twice the median (5.0/2.5) or 2.0 MoM. Similarly if the level is 5.0 iu/mL at 14 weeks this is half the median (5.0/10.0) or 0.5 MoM.Risk of Down's syndrome in relation to marker levels The graphs below show the overlapping relative frequency distributions of the markers in Down's pregnancies. The points of intersection are the value at which the risk of Down’s syndrome is the same as the background risk in the population. From these graphs, it can be seen that AFP, uE3 and PAPP-A values below 0.86 MoM, 0.83 MoM and 0.64 MoM respectively and NT, inhibin-A and free ?-hCG values above 1.46 MoM, 1.54 MoM and 1.67 MoM respectively will tend to increase the risk of Down’s syndrome above the background risk while values in the opposite directions will tend to decrease the risk below the background risk.Distribution curves:[url=images/riskcurves/riskcurves.pdf][/url]For a 75K PDF showing all six curves more clearly, please click any graph above.Factors affecting the test Maternal weight, ethnic group , In Vitro Fertilisation (IVF), Insulin Dependent Diabetes Mellitus (IDDM) and smokingSerum marker levels tend to be decreased in heavier women, and increased in lighter women.AFP levels tend to be about 20% higher, free ?-hCG and hCG levels about 10% higher and PAPP-A levels about 60% higher in Afro-Caribbean women than in Caucasian women.Free ?-hCG and hCG levels tend to be about 10% higher and uE3 levels about 10% lower in women who have become pregnant as a result of IVF compared with non-IVF pregnanciesAFP and uE3 levels tend to be low (about 8% and 6% respectively) in women with insulin dependent diabetes mellitus.PAPP-A, free ?-hCG and hCG levels tend to be about 20% lower and inhibin levels about 60% higher in women who smoke.Appropriate adjustments of the MoM values are made for these factors.TwinsThe serum marker levels are raised in twin pregnancies. Adjustments are made to take account of this.Screening in twin pregnancies poses a difficulty because of the possibility that one fetus may be affected and the other may not. Because of the presence of two fetuses the amniocentesis is a slightly more complex procedure in a twin pregnancy. If one twin is found to be affected and the other unaffected, selective feticide can be offered. This procedure poses a substantial risk to the unaffected twin. The presence of a twin pregnancy may therefore be seen by some women as a reason to avoid screening..........
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所谓的风险只是几率高低罢了看过50%高风险正常的，也看过低风险有问题的做产前诊断就行了。
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谢谢各位指点，准备去做羊水穿刺了
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不知楼主结果如何
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(*^__^*) 嘻嘻……，真是虚惊一场！小家伙健康聪明，现在已经满地跑，呀呀学语了，真诚感谢各位！
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产前筛查实施方案
活动方案范文：产前筛查实施方案是由第一范文站()为您精心收集，希望这篇产前筛查实施方案范文可以给您带来帮助，如果觉得好，请把这篇文章复制到您的博客或告诉您的朋友，以下是产前筛查实施方案的正文：
4 产前筛查实施方案
为进一步贯彻落实《xx市卫生局关于全面开展产前筛查工作的通知》（x卫办发[号）文件精神，推动和规范我镇产前筛查工作，提高我镇出生人口素质，根据《xx县产前筛查工作实施方案》，制定本方案。 一、筛查对象：年龄在35周岁以下，妊娠15-20+6周的孕妇。二、筛查项目：21-三体综合征、开放性神经管缺陷、18-三体综合征。三、筛查方法：母血清标志物三联法：抽取孕妇静脉血，制成血清标本，交由签署合作协议的筛查单位（xx市产前筛查机构）筛查胎儿罹患唐氏综合征、18-三体综合征和开放性神经管缺陷的风险。四、筛查机构产前筛查机构：xx市第二人民医院、翠屏区妇幼保健院。五、筛查程序（一）告知在实施产前筛查前，xx镇中心卫生院妇产科应当将产前筛查的目的、意义、方式、费用等情况如实告知孕妇，孕妇签署《产前筛查告知书》。告知书一式二份，孕妇和采血点各保存一份。以下情况书面告知孕妇直接进行相关产前诊断：预产期日年龄≥35周岁；生育过染色体异常胎儿；夫妻双方之一为染色体异常的平衡易位携带者；产前检查怀疑胎儿患染色体病；孕妇为X连锁遗传病基因携带者；生育过神经管缺陷患儿等的孕妇。（二）签署知情同意书具有资质的医师对同意产前筛查孕妇告知：产前筛查先天性疾病能达到的检出率、有可能出现假阴性、与产前诊断相比的局限性。孕妇知情理解后签署产前筛查知情同意书。（三）资料收集医师在产前筛查申请单上准确填写孕妇各项资料、超声测定结果及超声检查时间。孕妇在产前筛查申请单上签署知情同意书。（四）采血、贮存和运输按照无菌操作常规，取孕妇静脉血2 ml -3ml 收集于真空干燥采血管中。采血管标签上注明姓名、编号、采血日期。采用唯一编号，与申请单及采血登记本上的编号一致。采血后2小时内尽快分离血清（0.5-1.0ml），加塞密封冰冻保存（血清标本注明姓名、编号、采血日期）。采集后5日内连同知情同意书送到签署合作协议的筛查单位，标本运送过程保持4-8℃（可用冰袋或冷藏箱）。（五）不合格标本及产前筛查机构出具书面报告领取对产前筛查机构接收标本时核定的不符合要求的标本应由送检人员带回，通知采血单位重新采集送检。产前筛查机构出具检测书面报告由送检人员带回，各医疗机构在送标本时签字领回。（六）追踪、确诊和跟踪随访产前筛查结果提示高风险孕妇，由筛查单位负责登记在产前筛查高风险孕妇登记本上，同时电话通知采血点妇幼人员转妇产科医生；妇产科医生以书面形式告知孕妇并及时转诊至xx市第二人民医院、翠屏区妇幼保健院进行产前诊断，同时对该孕妇进行追踪随访并登记随访结果在产前筛查高风险孕妇登记本上。因地址不详或拒绝确诊等原因而失访者，采血点及筛查单位应当注明原因。六、结果应用（一） 唐氏综合征筛查结果采用1／250为阳性切割值（临界值），即筛查结果风险率≥1／250者为高风险妊娠。（二） 18三体综合征筛查结果采用1／350为阳性切割值，筛查结果风险率≥1／350者为高风险妊娠。（三）开放性神经管缺陷以母血清AFP≥2.5MOM为阳性切割值，筛查结果AFP≥2.5MOM者为高风险妊娠。以上三项检测结果其中一项为高风险者纳入追踪管理，并进行产前诊断。七、项目工作组组& 长：张x　& （院长）副组长：岳x （副院长，公卫科长）成& 员：秦x（妇产科主任）黄x（妇产科医生）李x（妇产科医生）黄x（检验医生）王x（检验医生）黄x（检验医生）王x（妇幼人员）肖x（公卫科人员）周x（办公室工作人员）xx镇中心卫生院检验科具体负责产前筛查的采血工作。采血时间：每周一至每周四10点钟以前。送血时间：每周四10点钟以后由周理送到xx市第二人民医院、翠屏区妇幼保健院。八、信息管理检验科每月将数据报公卫科妇幼人员王淑琼，由王淑琼在每月25前随月报表报县妇幼保健院保健科。九、实施步骤1、2012年8月：开展产前筛查知识宣传教育，制定实施方案；组织相关业务科室人员进行学习。2、2012年9月_12月：全面开展产前筛查工作。我院筛查采血率达到20%以上。 4
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备案号：鄂ICP备号 未经授权禁止复制或建立镜像 违责必究唐氏筛查结果 AFP:15ng/ml 0.5769MOM HCG:14200miu/ml o.7734MOM 唐氏风险率：1:845 风险率截断值 1:200_百度宝宝知道