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中华妇幼临床医学杂志(电子版) ›› 2024, Vol. 20 ›› Issue (05) : 486 -492. doi: 10.3877/cma.j.issn.1673-5250.2024.05.002

产科前沿专辑

《2024意大利妇产科学会非侵入性和侵入性产前诊断指南》解读
钱警语1, 郑明明1,()   
  1. 1.安徽省妇女儿童医学中心胎儿医学中心,合肥 230001
  • 收稿日期:2024-08-01 修回日期:2024-09-25 出版日期:2024-10-01
  • 通信作者: 郑明明
  • 基金资助:
    安徽省卫生健康科研项目(AHWJ2023A20259)

Interpretation of the Italian guidelines on non-invasive and invasive prenatal diagnosis:executive summary of recommendations for practice the Italian Society for Obstetrics and Gynecology(SIGO)

Jingyu Qian1, Mingming Zheng1,()   

  1. 1.Department of Fetal Medical Center,Anhui Women and Children's Medical Center,Hefei 230001,Anhui Province,China
  • Received:2024-08-01 Revised:2024-09-25 Published:2024-10-01
  • Corresponding author: Mingming Zheng
引用本文:

钱警语, 郑明明. 《2024意大利妇产科学会非侵入性和侵入性产前诊断指南》解读[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 486-492.

Jingyu Qian, Mingming Zheng. Interpretation of the Italian guidelines on non-invasive and invasive prenatal diagnosis:executive summary of recommendations for practice the Italian Society for Obstetrics and Gynecology(SIGO)[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(05): 486-492.

2024年意大利妇产科学会(SIGO)针对侵入性与非侵入性产前诊断的应用,颁布《意大利妇产科学会非侵入性和侵入性产前诊断指南》[theItalianguidelinesonnon-invasiveandinvasive prenataldiagnosisexecutivesummaryofrecommendationsforpracticetheItalianSocietyfor ObstetricsandGynecologySIGO)](以下简称为《PD 指南》)。该指南基于目前文献中可获得最佳证据,针对产前筛查及产前诊断中常见问题提出建议,旨在优化产前筛查及产前诊断方案。笔者拟就《PD 指南》中各种产前筛查方案进行比较,以及对侵入性产前诊断前遗传咨询、传染性疾病孕妇的侵入性产前诊断的相关建议,侵入性产前诊断检测的遗传学项目及操作要求等内容进行详细解读。

In 2024,the Italian Society for Obstetrics and Gynecology (SIGO)released the Italianguidelinesonnon-invasiveandinvasiveprenataldiagnosisexecutivesummaryof recommendationsforpracticetheItalianSocietyforObstetricsandGynecologySIGO) (hereinafter referred to as the"PD Guidelines")addressing the application of invasive and non-invasive prenatal diagnosis.The guidelines are founded on the best available evidence from current literature and provide recommendations for common issues in prenatal screening and prenatal diagnosis,aiming to optimize prenatal screening and prenatal diagnosis procedures.The authors intend to compare various prenatal screening protocols in the PD Guidelines,and provide detailed explanations on the recommendations for genetic counseling prior to invasive prenatal diagnosis,recommendations for invasive prenatal diagnosis for pregnant women with infectious diseases,genetic testing items for invasive prenatal diagnosis,and operational requirements.

表1 《PD 指南》证据水平(质量)分级体系
表2 《PD 指南》推荐级别(强度)分级体系
表3 单胎妊娠孕妇NIPT 的胎儿13-、18-和21-三体检出结果比较
表4 NIPT 作为一、二线筛查方案对21-三体综合征胎儿检出结果比较
[1]
中华人民共和国卫生部.中国出生缺陷防治报告(2012)[EB/OL].(2012-09-07)[2024-09-28].http://www.nhc.gov.cn/wsb/pxwfb/201209/55840/files/0af7007b1a6846939 7531b154d9425f9.pdf.Ministry of Health of the People's Republic of China.China birth defect prevention and control report (2012) [EB/OL].(2012-09-07)[2024-09-28].http://www.nhc.gov.cn/wsb/pxwfb/201209/55840/files/0af7007b1a68469397531b154d94 25f9.pdf.
[2]
Stampalija T,Ghi T,Barbieri M,et al.The Italian guidelines on non-invasive and invasive prenatal diagnosis:Executive summary of recommendations for practice the Italian Society for Obstetrics and Gynecology (SIGO)[J].Eur J Obstet Gynecol Reprod Biol,2024,300:171-174.DOI:10.1016/j.ejogrb.2024.07.012.
[3]
The GRADE Working Group.Criteria for applying or using GRADE(2016)[EB/OL].(2016-03-16)[2024-09-28].https://www.gradeworkinggroup.org/docs/Criteria_for_using_GRADE_2016-04-05.pdf.
[4]
Hui L,Hutchinson B,Poulton A,et al.Population-based impact of noninvasive prenatal screening on screening and diagnostic testing for fetal aneuploidy[J].Genet Med,2017,19(12):1338-1345.DOI:10.1038/gim.2017.55.
[5]
Elmerdahl Frederiksen L,lgaard SM,Roos L,et al.Maternal age and the risk of fetal aneuploidy:a nationwide cohort study of more than 500 000 singleton pregnancies in Denmark from 2008 to 2017[J].Acta Obstet Gynecol Scand,2024,103(2):351-359.DOI:10.1111/aogs.14713.
[6]
Mikwar M,MacFarlane AJ,Marchetti F.Mechanisms of oocyte aneuploidy associated with advanced maternal age[J].Mutat Res Rev Mutat Res,2020,785:108320.DOI:10.1016/j.mrrev.2020.108320.
[7]
苏杭, 刘之英, 赖怡, 等.高龄孕妇产前诊断结果及其首选无创产前筛查局限性的大样本分析[J/OL].中华妇幼临床医学杂志(电子版),2018,14(6):718-723.DOI:10.3877/cma.j.issn.1673-5250.2018.06.015.Su H,Liu ZY,Lai Y,et al.Prenatal diagnosis results of advanced maternal age women and limitations of preferred non-invasive prenatal screening to them:a large sample analysis[J/OL].Chin J Obstet Gynecol Pediatr(Electron Ed),2018,14(6):718-723.DOI:10.3877/cma.j.issn.1673-5250.2018.06.015.
[8]
Suciu I,Galeva S,Abdel Azim S,et al.First-trimester screening-biomarkers and cell-free DNA[J].J Matern Fetal Neonatal Med,2021,34(23):3983-3989.DOI:10.1080/14767058.2019.1698031.
[9]
Department of Health.Australian Government(2020)pregnancy care clinical practice guidelines[EB/OL].(2020-06-02) [2024-03-20].https://www.health.gov.au/resources/pregnancy-care-guidelines.
[10]
Choe SA,Seol HJ,Kwon JY,et al.Clinical practice guidelines for prenatal aneuploidy screening and diagnostic testing from Korean Society of Maternal-Fetal Medicine: (1)Prenatal Aneuploidy Screening[J].J Korean Med Sci,2021,36(4):e27.DOI:10.3346/jkms.2021.36.e27.
[11]
Linee guida per ecografia ostetrica e ginecologica.Società Italiana di Ecografia Ostetrico Ginecologica e Metodologie Biofisiche per Istituto Superiore di Sanità[EB/OL].(2021-11-09)[2024-03-11].https://snlg.iss.it/wp-content/uploads/2021/11/LG-SIEOG-2021_def.pdf.
[12]
American College of Obstetricians and Gynecologists'Committee on Practice Bulletins—Obstetrics,Committee on Genetics,Society for Maternal-Fetal Medicine.Screening for fetal chromosomal abnormalities:ACOG practice bulletin,number 226[J].Obstet Gynecol,2020,136(4):e48-e69.DOI:10.1097/AOG.0000000000004084.
[13]
Gil MM,Accurti V,Santacruz B,et al.Analysis of cell-free DNA in maternal blood in screening for aneuploidies:updated Meta-analysis[J].Ultrasound Obstet Gynecol,2017,50(3):302-314.DOI:10.1002/uog.17484.
[14]
Sebire E,Rodrigo CH,Bhattacharya S,et al.The implementation and impact of non-invasive prenatal testing(NIPT)for Down's syndrome into antenatal screening programmes:a systematic review and Meta-analysis[J].PLoS One,2024,19(5):e0298643.DOI:10.1371/journal.pone.0298643.
[15]
Lannoo L,Van Camp J,Brison N,et al.What helps define outcomes in persistent uninterpretable non-invasive prenatal testing:maternal factors,fetal fraction or quality scores?[J].Prenat Diagn,2023,43(10):1333-1343.DOI:10.1002/pd.6423.
[16]
CSS Consiglio Superiore di Sanità.Ministero della Salute(2021)Screening del DNA fetale non invasivo (NIPT)in sanitàpubblica[EB/OL].(2021-10-26) [2024-09-01].https://www.salute.gov.it/imgs/C_17_pubblicazioni_3097_allegato.pdf.
[17]
Merriel A,Alberry M,Abdel-Fattah S.Implications of noninvasive prenatal testing for identifying and managing high-risk pregnancies[J].Eur J Obstet G ynecol Reprod Biol,2021,256(1):32-39.DOI:10.1016/j.ejogrb.2020.10.042.
[18]
Bellai-Dussault K,Dougan SD,Fell DB,et al.Ultrasonographic fetal nuchal translucency measurements and cytogenetic outcomes[J].JAMA Netw Open,2024,7(3):e243689.DOI:10.1001/jamanetworkopen.2024.3689.
[19]
Liao Y,Wen H,Ouyang S,et al.Routine first-trimester ultrasound screening using a standardized anatomical protocol[J].Am J Obstet Gynecol,2021,224(4):396.e1-396.e15.DOI:10.1016/j.ajog.2020.10.037.
[20]
Pauta M,Martinez-Portilla RJ,Borrell A.Diagnostic yield of next-generation sequencing in fetuses with isolated increased nuchal translucency:systematic review and Meta-analysis[J].Ultrasound Obstet Gynecol,2022,59(1):26-32.DOI:10.1002/uog.23746.
[21]
Petrovski S,Aggarwal V,Giordano JL,et al.Whole-exome sequencing in the evaluation of fetal structural anomalies:a prospective cohort study[J].Lancet,2019,393(10173):758-767.DOI:10.1016/S0140-6736(18)32042-7.
[22]
The Royal Australian and New Zeland College of Obstetricians and Gynecology.Reproductive carrier screening[EB/OL].(2019-03) [2024-03-15].https://ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Statement% 20and% 20guidelines/Clinical-Obstetrics/Genetic-carrier-screening(C-Obs-63)New-March-2019_1.pdf? ext=.pdf.
[23]
Fontoura Oliveira A,Torrão MM,Nogueira R,et al.Recurrent fetal triploidy:is there a genetic cause? [J].BMJ Case Rep,2021,14(3):e239843.DOI:10.1136/bcr-2020-239843.
[24]
Practice bulletin No.162:prenatal diagnostic testing for genetic disorders[J].Obstet Gynecol,2016,127(5):e108-e122.DOI:10.1097/AOG.0000000000001405.
[25]
Lee JY,Kwon JY,Na S,et al.Clinical practice guidelines for prenatal aneuploidy screening and diagnostic testing from Korean Society of Maternal-Fetal Medicine: (2)invasive diagnostic testing for fetal chromosomal abnormalities[J].J Korean Med Sci,2021,36(4):e26.DOI:10.3346/jkms.2021.36.e26.
[26]
Navaratnam K,Alfirevic Z,Royal College of Obstetricians and Gynaecologists.Amniocentesis and chorionic villus sampling:Green-top Guideline No.8 July 2021:Green-top Guideline No.8[J].BJOG,2022,129(1):e1-e15.DOI:10.1111/1471-0528.16821.
[27]
Management of hepatitis c in pregnancy[EB/OL].(2020-03)[2024-03-22].https://ranzcog.edu.au/wp-content/uploads/2022/05/Management-of-Hepatitis-C-in-Pregnancy-C-Obs-51.pdf.
[28]
王静, 闫涛涛, 冯亚丽, 等.母亲HBV DNA 载量对宫内传播及胎儿宫内窘迫的影响[J].中华肝脏病杂志,2022,30(8):873-878.DOI:10.3760/cma.j.cn501113-20190610-00207.Wang J,Yan TT,Feng YL,et al.The effect of maternal HBV DNA levels on HBV intrauterine transmission and fetal distress[J].Chin J Hepatol,2022,30(8):873-878.DOI:10.3760/cma.j.cn501113-20190610-00207.
[29]
Tess BH,Rodrigues LC,Newell ML,et al.Breastfeeding,genetic,obstetric and other risk factors associated with mother-to-child transmission of HIV-1 in Sao Paulo State,Brazil.Sao Paulo Collaborative Study for Vertical Transmission of HIV-1[J].AIDS,1998,12(5):513-520.DOI:10.1097/00002030-199805000-00013.
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