Retrospective and cost-effective analysis of the result of Changsha Municipal Public Welfare Program by Noninvasive Prenatal Testing / 中华医学遗传学杂志

OBJECTIVE@#To assess the practical and health economical values of non-invasive prenatal test (NIPT) in Changsha Municipal Public Welfare Program.@*METHODS@#A retrospective analysis was carried out on 149 165 women undergoing NIPT test from April 9, 2018 to December 31, 2019. For pregnant women with high risks, invasive prenatal diagnosis and follow-up of pregnancy outcome were conducted. The cost-benefit of NIPT for Down syndrome was analyzed.@*RESULTS@#NIPT was carried out for 149 165 pregnant women and succeeded in 148 749 cases (99.72%), for which outcome were available in 148 538 (99.86%). 90% of pregnant women from the region accepted the screening with NIPT. 415 (0.27%) were diagnosed as high risk. Among these, 381 (91.81%) accepted amniocentesis, which led to the diagnosis of 212 cases of trisomy 21 (PPV=85.14%), 41 cases with trisomy 18 (PPV=48.81%) and 10 cases with trisomy 13 (PPV=20.83%). The sensitivity and specificity of NIPT for trisomy 21, trisomy 18 and trisomy 13 were (97.70%, 99.98%), (97.62%, 9.97%) and (100%, 99.97%), respectively. In addition, 213 and 30 cases were diagnosed with sex chromosomal aneuploidies (PPV=46.2%) and other autosomal anomalies (PPV=16.57%), respectively. For Down syndrome screening, the cost and benefit of the project was 120.79 million yuan and 1,056.95 million yuan, respectively. The cost-benefit ratio was 1: 8.75, and safety index was 0.0035.@*CONCLUSION@#NIPT is a highly accurate screening test for trisomy 21, which was followed by trisomy 18 and sex chromosomal aneuploidies, while it was less accurate for other autosomal aneuploidies. The application of NIPT screening has a high health economical value.

Risk factors for the formation of aberrant artery collaterals in the uterus with scar in pregnancy womenunderwent cesarean / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the prevalence and risk factors for the formation of aberrant artery collaterals in the uterus during uterine artery embolization (UAE).
@*METHODS@#The data of 144 women with scar in the uterus due to cesarean were retrospectively analyzed. They underwent UAE in the period of 2009-2014 and were divided into two groups according to a standard with or without the aberrant artery collaterals in the uterus. The risk factors were analyzed.
@*RESULTS@#Aberrant artery collaterals were found in thirty-four patients. According to multiple logistic regression analysis, the presence of placenta previa (RR=78.556, 95% CI: 2.869-2 150.651, P=0.010), pelvic inflammatory disease (RR=6.633, 95% CI: 1.595-27.592, P=0.009), pregnancy complications (RR=7.264, 95% CI: 1.622-32.531, P=0.010), abortions (RR=18.381, 95% CI: 1.683-200.752, P=0.017) and uterine fibroids or adenomyosis (RR=12.580, 95% CI: 1.004-157.550, P=0.050) were the factors for the presence of aberrant artery collaterals.
@*CONCLUSION@#Aberrant artery collaterals were more frequent in patients with pelvic inflammatory disease, pregnancy complications, abortions and uterine fibroids or adenomyosis.

Expression of aspartyl-(asparaginyl) beta-hydroxylase in villi in patients with missed abortion / 中南大学学报(医学版)

OBJECTIVE@#To determine the difference in aspartyl-(asparaginyl) beta-hydroxylase (AAH) expression level in villi between patients with missed abortion and normal women with early pregnancy, and to confirm the expression loci of AAH in villi.@*METHODS@#A total of 50 patients of missed abortion were collected and categorized into a test group, which was subdivided into Group 1 and Group 2. Patients in Group 1 (n=20) were of confirmed etiological disorders while those in Group 2 (n=30) showed no obviously etiological clues. In addition, 20 women of early pregnancy with artificial abortion were categorized into a control group, whose embryos were sonographically confirmed alive before surgery. The 50 patients of missed abortion were also subdivided into a group within 4 weeks and a group over 4 weeks according to the time that the embryo stayed in utrine after death. Immunohistochemical technique and computer image analysis were used to detect the expression loci and the level of AAH in villi.@*RESULTS@#AAH was expressed in the endochylema and nucleus of trephocyte both in missed abortion and normal early pregnancy. The expression level of AAH in villi of missed abortion was much lower than that of in villi of normal early pregnancy (P0.05).@*CONCLUSION@#Low expression of AAH in the endochylema and nucleus of trephocyte may play a role in patients with missed abortion.