乙肝孕妇介入性产前诊断的现状分析 [中文引用][英文引用]

目的 了解目前乙肝孕妇行介入性产前诊断的一般情况。方法 回顾性分析2017年7月至2018年6月期间来广东省妇幼保健院产前诊断科进行介入性产前诊断或宫内治疗的乙肝表面抗原（HBsAg）阳性的孕妇资料，总结分析年龄、穿刺孕周、胎数、手术类型、穿刺指征、HBsAg、HBeAg、乙肝病毒DNA定量、是否经过胎盘、穿刺次数、是否胎心下降和产前诊断结果等信息。结果 1年内进行产前诊断的孕妇共9251例，总760例孕妇（8.22%）纳入，其中绒毛吸取术108例（14.21%），羊膜腔穿刺术495例（65.13%），脐静脉穿刺术157例（20.66%），宫内治疗23例（同时行产前诊断）。HBsAg阳性合并HBeAg阳性孕妇共185例（24.34%），HBsAg阳性合并HBeAg阴性的孕妇共480例（63.16%），HBeAg阳性和HBeAg阴性的孕妇中分别有128例（75.74%）和7例（1.76%）外周血乙肝病毒定量大于106IU/ml。总共检出123例（16.18%）异常产前诊断结果。结论 乙肝孕妇在行介入性产前诊断孕妇中的比例与人群中的携带率相符，为降低母胎传播风险，乙肝孕妇行介入性产前诊断前应完善HBeAg及病毒定量检测，充分了解穿刺的宫内感染风险后再行检查。

Objective Discuss the general situation of invasive prenatal diagnosis of pregnant women with hepatitis B. Method We retrospectively analyzed the informations of pregnant women with hepatitis B surface antigen (HBsAg) positive for invasive prenatal diagnosis or intrauterine treatment in the Prenatal Diagnosis Department of Guangdong Women and Children’s Hospital from July 2017 to June 2018, including age, puncture pregnancy week, number of fetuses, type of surgery, indications for puncture, HBsAg, HBeAg, HBV DNA quantification, whether through the the placenta, number of punctures, whether fetal heart rate dropping, and the outcome of prenatal diagnosis. Results A total of 9251 pregnant women undergoing prenatal diagnosis within this year. A total of 760 pregnant women (8.22%) were included, in which 108 cases undergoing chorionic villi sampling (14.21%), 485 cases for amniocentesis (63.81%) , 144 cases for percutaneous umbilical blood sampling (18.94%) and 23 cases for intrauterine treatment. There were a total of 185 (24.34%) pregnant women with HBsAg-positive and HBeAg-positive, 480 (63.16%) with HBsAg-positive and HBeAg-negative pregnant women. 128(75.74%) with HBeAg(+) and 7(1.76%) with HBeAg(-) pregnant women had a quantitative amount of hepatitis B virus of 106 IU/ml. A total of 123 (16.18%) abnormal prenatal diagnosis results were detected. Conclusions The proportion of pregnant women with hepatitis B in invasive prenatal diagnosis is consistent with the infection rate in the population. HBeAg and virus quantitative testing should be completed before invasive prenatal diagnosis of hepatitis B pregnant women, and the risk of intrauterine infection of puncture should be fully understood before testing.