| Perinatal women and fetal diseases are not only serious threat to the quality of life and health of pregnant women, but also have an adverse impact on the socio-economic, family happiness. Therefore, prenatal screening for the disease clinical decision-making is very important for reducing the occurrence of birth defects.Down syndrome, also known as trisomy 21, is a common cause of mental retardation and congenital cardiovascular malformations chromosomal disorders. IQ in these children is usually one-quarter to one-half of normal children (usually 30-60). Down syndrome has no cure yet, society and families of children with heavy financial pressure. Prenatal screening is effective detection and prevention of the key technologies of the birth defects in children. Currently the main screening methods are using the mother serological. But all countries and regions selected prenatal screening program for Down syndrome is different, so the systematic evaluation of different screening programs, and has become an important problem in clinical decision-making. In recent years, the second joint second trimester serum screening programs for women (using maternal serum markers alpha-fetoprotein (AFP), human chorionic gonadotropin β subunit (free β-hCG)) and second-trimester serum screening programs for women triple (using maternal serum markers alpha-fetoprotein (AFP), human chorionic gonadotropin β subunit (free β-hCG), unconjugated estriol (unconjugated estrial, uE3)) studies have reported more, but the research is still no unified conclusion.Preeclampsia is a pregnancy-specific human disease, usually occurs after 20 weeks of pregnancy, pregnancy complications occur proteinuria and hypertension clinical manifestations, a serious threat to maternal and child health. So far, the etiology of the disease is uncertain, still not able to find a high-risk population screening for disease markers. In recent years, high levels of maternal serum human chorionic gonadotropin and studies have reported the relationship between preeclampsia and more, but the relationship between the two studies is no unified conclusion.To further clarify the second trimester serum double screening, triple screening program for Down syndrome and high levels of maternal serum human chorionic gonadotropin free screening of preeclampsia efficiency, to better clinical application, the subject for more than three issues were made Meta-analysis.Meta-analysis through the integration of a large number of clinical studies significantly increased the number of samples, increasing the statistical power of conclusions can be drawn from a comprehensive understanding of the problem, to solve the problem of disagreement among the experts. Therefore, this study retrieved articles PubMed, Embase, CNKI and other databases totaling 596, included in the study 64. For second-trimester maternal serum screening indicators bivalent trisomy 21 Meta-analysis:a sensitivity of 71% (95% confidence interval:67%-75%), specificity was 95%(95% confidence interval:95%-95%), diagnostic odds ratio DOR was 39.46 (95% CI:28.33-54.98), area under the curve was 0.9677. Trimester serum screening for Down syndrome triple indicators for women Meta-analysis of the results were as follows:sensitivity 72%, specificity 92%, diagnostic odds ratio was 30.17 DOR area under the curve was 0.89. Maternal serum human chorionic gonadotropin screening of pregnant women with preeclampsia sensitivity of 37% (95% confidence interval:34%-41%), specificity was 88%(95% confidence interval: 88%-89%), area under the curve was 0.6259.The above three methods as a way of prenatal screening high-risk groups all have certain efficiency, including the joint plan was slightly better than the second league, but both efficiency and no significant difference. Maternal serum human chorionic gonadotropin screening preeclampsia has a certain efficiency, if we can combine more serum markers might be better screening effect.
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