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題名 | Second-Trimester Maternal Serum Levels of Alpha-Fetoprotein, Free β-Subunit of Human Chorionic Gonadotropin and CA-125 in Twin Pregnancy after Multifetal Pregnancy Reduction=減胎術對懷孕中期母血甲型胎兒蛋白,人類絨毛性腺激素游離型β次單元和CA-125濃度的影響 |
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作者 | 柯滄銘; 鍾宜珮; 華筱玲; 呂佩貞; 陳秀熙; | 書刊名 | 中華民國婦產科醫學會會刊雜誌 |
卷期 | 37:3 1998.09[民87.09] |
頁次 | 頁87-92 |
分類號 | 417.349 |
關鍵詞 | 以母血篩檢胎兒唐氏症; 甲型胎兒蛋白; 人類絨毛性腺激素; 癌症抗原-125; 減胎術; 雙胞胎; Maternal serum screening for down syndrome; Alpha-fetoprotein; Human chorionic gonadotropin; Cancer antigen-125; Multifetal pregnancy reduction; Twin pregnancy; |
語文 | 英文(English) |
中文摘要 | 目的:為探討多胞胎減為雙胞胎之後,懷孕中期時母血甲型胎兒蛋白,人類絨毛 性腺激素游離型β次單元和 CA-125 濃度受到的影響。 方法:第一實驗組包含從三胞胎減為雙胞胎的 27 位孕婦,第二實驗組包含從四胞胎減為雙 胞胎的 16 位孕婦。對照組為 52 例沒有經過減胎手術的雙胞胎孕婦。對照組以及經過減胎 後的孕婦於懷孕 16 至 18 週時抽血檢查其甲型胎兒蛋白,人類絨毛性腺激素游離型β次單 元和 CA-125 的濃度。甲型胎兒蛋白和人類絨毛性腺激素游離型β次單元和濃度的測定採用 冷光酵素免疫分析法。最後利用 Wilcoxon rank-sum test 比較三種血清物質在三組孕婦之 間的差異。 結果:第一實驗組在懷孕 16 和 17 週時,母血的甲型胎兒蛋白濃度比對照組有顯著升高, 而第二實驗組在懷孕 16 到 18 週時,皆顯著偏高。第二實驗組的甲型胎兒蛋白濃度皆比第 一實驗組高。母血的絨毛性腺激素游離型β次單元和 CA-125 濃度在三組之間皆沒有顯著差 異。 結論:減胎之後,母血的甲型胎兒蛋白濃度在懷孕 16 到 18 週時有顯著偏高的情形,四胞 胎減為雙胞胎者其偏高情形比三胞胎減為雙胞胎者更為明顯。目前在懷孕中期時利用甲型胎 兒蛋白以篩檢胎兒罹患唐氏症機率的各種方法不可使用於減胎之後的個案,否則會產生嚴重 的誤差。 |
英文摘要 | Objective: To evaluate the impact of multifetal pregnancy reduction (MFPR) on second-trimester maternal serum levels of alpha-fetoprotein (AFP), the free β -subunit of human chorionic gonadotropin (β -hCG) and cancer antigen (CA)-125. Methods: Study group l consisted of 27 pregnancies in which MFPR had been performed to reduce triplet to twin pregnancies. Study group Ⅱ consisted of 16 pregnancies in which MFPR had been performed to reduce quadruplet to twin pregnancies. Maternal blood was obtained at 16 to 18 weeks of gestation for quantification of AFP, β -hCG and CA-125. The control group consisted of 52 twin pregnancies in which no MFPR was done. Maternal blood was drawn at 16 to 18 weeks of gestation for comparison with the study groups. AFP and β -hCG were quantified with a chemiluminescent enzyme immunoassay and CA-125 with an enzyme-linked immunoassay. The Wilcoxon rank-sum test was used to compare the differences between the median and mean levels of the serum markers in the three groups. Results: The maternal serum AFP levels in the study group l were higher than those in the control group in the samples at 16 and 17 weeks of gestation, while those in the study group Ⅱ were higher than those in the control group in the samples at 16 through 18 weeks of gestation. The maternal serum AFP levels of the study groups Ⅱ were higher than those of the study group l. Maternal serum β -hCG and CA-125 levels were not significantly different among the three groups. Conclusion: The second-trimester maternal serum Down syndrome screening programs that include AFP could lead to misinterpretations in pregnancies in which MFPR has been previously performed. |
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