羊水穿刺和无创哪个好

2018-12-04 15:54 阅读: 编辑: 来源:网络
标签: 羊水穿刺
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内容简介:羊水穿刺和无创DNA产前检测是孕妈们在孕检时经常会遇到的产前检查项目,到底是做无创还是做羊水穿刺,很多孕妈们都不知道该选择哪一项,到底是羊水穿刺好,还是无创DNA产前检测好呢?

羊水穿刺和无创DNA产前检测是孕妈们在孕检时经常会遇到的产前检查项目,到底是做无创还是做羊水穿刺,很多孕妈们都不知道该选择哪一项,到底是羊水穿刺好,还是无创DNA产前检测好呢?  

羊水穿刺和无创所针对的都是产前胎儿畸形的诊断,它们各有各的优势,也各有各的缺点。  

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一、羊水穿刺检查范围更广、更准确  

羊水穿刺是一个确诊的实验,它是从羊水中提取胎儿的细胞做检测,能够检查胎儿所有染色体是否异常,而且对于染色体异常的所有类型(嵌合型、易位型)也都能够检测。  

而无创DNA产前检测是一个筛查实验,它是通过抽取孕妇的血液,从中提取出胎儿的游离DNA进行测序,并将测序结果进行生物信息分析,得出胎儿的遗传信息,以此判断胎儿是否有可能患有21-三体、18-三体和13-三体综合征。  

无创DNA和人们熟悉的唐氏筛查一样,同样都是一个风险筛查,只是无创的筛查结果准确率比唐氏筛查的准确率高,能达到99%。不过这99%的准确率也只是针对第13、18和21号染色体,对于其余的20对染色体异常,无创是检测不出来的。还有出现概率很低的染色体嵌合型异常,无创DNA产前检测也是检测不到的。还有就是如果无创的结果显示高风险,还是需要做羊水穿刺来确诊的。  

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二、羊水穿刺风险大于无创  

所谓无创DNA产前检测,就是对于孕妇身体没有创伤,不会造成任何风险,只需要抽取几毫升孕妇的外周血就可以完成风险评估。  

而羊水穿刺则是一种有创的诊断方式,有创就有风险,羊水穿刺可能造成孕妇出血,羊水渗漏,感染以及流产的风险。而且羊水穿刺后细胞培养也有可能失败,那么就可能需要重新做羊水穿刺。  

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三、如何选择?  

如果只是唐氏筛查高风险,而B超检查等其他产检项目都正常,可以选择做无创DNA检测,筛查胎儿是否可能属于21-三体、18-三体和13-三体染色体异常,毕竟其他20对染色体出现异常的几率比较小。  

如果在B超检查中提示胎儿有结构异常,或者产前筛查异常,如无创检测高风险、唐氏筛查风险在1/50以上、早孕时NT值大于3.5mm的,都建议做羊水穿刺。还有曾经生育过染色体病患儿的孕妇,夫妇一方为染色体异常携带者,孕妇可能为X连锁遗传病基因携带者的这三种情况也必须做羊水穿刺,因为这些情况生育染色体病的胎儿几率大,而无创DNA的检测结果会受到影响导致不够准确。


标签: 羊水穿刺
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