胎儿颈项透明层测值与妊娠不良结局的相关性分析
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摘要
目的探讨胎儿颈项透明层(NT)不同厚度与妊娠不良结局的关系。方法选取胎儿NT值增厚的孕妇78例,根据NT不同厚度分为四组:Ⅰ组2.5～3.0mm,Ⅱ组3.1～4.0mm,Ⅲ组4.1～5.0mm,Ⅳ组NT>5.0mm,随访NT增厚胎儿妊娠结局。结果胎儿NT增厚者包括单纯NT增厚者45例,妊娠结局不良者33例,妊娠结局不良组较单纯NT增厚组在孕妇年龄、胎儿NT厚度、染色体及结构异常发生率比较均有统计学意义(P<0.05)。NT值不同厚度分组比较,NT值>4.0mm的Ⅲ、Ⅳ组妊娠不良结局发生率明显高于Ⅰ、Ⅱ组(P<0.05),发生率分别为100%、92%。结论胎儿NT厚度可以作为孕早期筛查预测妊娠不良结局的重要指标。随着NT测值增加,胎儿妊娠不良结局的概率增大。
Objective To evaluate the relationship between fetal nuchal translucency thickness and adverse pregnancy outcome.Methods We reviewed the outcome of 78 pregnancies with increased NT during the first trimester between.Fetuses were divided into four groups according to various NT levels:group Ⅰ(2.5-3.0 mm),group Ⅱ(3.1-4.0 mm),group Ⅲ(4.1-5.0 mm),group Ⅳ(NT>5.0 mm).Particular attention was paid to the relationship between NT thickness and subsequent pregnancy outcome.Results 45 fetuses were found with simple thickening of NT and 33 fetuses were found with thickening of NT and adverse pregnancy outcome.The two groups were statistically significant(P<0.05)in terms of age,the degree of increase in NT and the incidence of chromosomal anomaly and structural abnormality.According to various NT levels,the incidence of adverse pregnancy outcome in group Ⅲ,group Ⅳwith NT>4.0 mm was 100%and 92%,significantly higher than that of group Ⅰ,group Ⅱ(P<0.05).Conclusions Fetal NT thickness in early pregnancy can be used to predict adverse pregnancy outcome.The odds for adverse outcomes can be predicted higher with increasing NT.
Objective To evaluate the relationship between fetal nuchal translucency thickness and adverse pregnancy outcome.Methods We reviewed the outcome of 78 pregnancies with increased NT during the first trimester between.Fetuses were divided into four groups according to various NT levels:group Ⅰ(2.5-3.0 mm),group Ⅱ(3.1-4.0 mm),group Ⅲ(4.1-5.0 mm),group Ⅳ(NT>5.0 mm).Particular attention was paid to the relationship between NT thickness and subsequent pregnancy outcome.Results 45 fetuses were found with simple thickening of NT and 33 fetuses were found with thickening of NT and adverse pregnancy outcome.The two groups were statistically significant(P<0.05)in terms of age,the degree of increase in NT and the incidence of chromosomal anomaly and structural abnormality.According to various NT levels,the incidence of adverse pregnancy outcome in group Ⅲ,group Ⅳwith NT>4.0 mm was 100%and 92%,significantly higher than that of group Ⅰ,group Ⅱ(P<0.05).Conclusions Fetal NT thickness in early pregnancy can be used to predict adverse pregnancy outcome.The odds for adverse outcomes can be predicted higher with increasing NT.
引文
[1]江美丽,廖灿.胎儿颈项透明层厚度在早孕期筛查胎儿畸形的研究进展[J].中国优生与遗传杂志,2011,19(6):123-125.
[2] YOSHIDA S, MIURA K,YAMASAKI K,et al.Dose increased nuchal translucency indicate a fetal abnormality?A retrospective study to clarify the clinical significance of nuchal translucency in Japan[J].J Hum Genet,2008,53(8):688-693.
[3] WESTIN M,SALTVEDT S,ALMSTROM H,et al.By how much does increased nuchal translucency increase the risk of adverse pregnancy outcome in chromosomally normal fetuses?A study of 16260fetuses derived from an unselected pregnant population[J].Ultrasound Obstet Gynecol,2007,29(2):150-158.
[4] KAGAN K O,AVGIDOU K,MOLINA F S,et al.Relation between increased fetal nuchal translucency thickness and chromosomal defects[J].Obstet Gynecol,2006,107(1):6-10.
[5]王莉,吴青青,陈焰,等.标准化超声切面筛查孕11~13+6周胎儿结构畸形的临床意义[J/OL].中华医学超声杂志:电子版,2014,11(1):25-31.
[6]裴秋艳,张晓红,李建国,等.胎儿颈项透明层增厚及静脉导管血流频谱异常在先天性心脏畸形筛查中的价值[J].中国超声医学杂志,2011,27(2):169-172.
[7] AKSAM S,PLESINAC S,DOTLIC J,et al.First trimester ultrasonographic parameters in prediction of the course and outcome of monochorionic twin pregnancies[J].Turk J Med Sci,2017,47(3):934-941.
[2] YOSHIDA S, MIURA K,YAMASAKI K,et al.Dose increased nuchal translucency indicate a fetal abnormality?A retrospective study to clarify the clinical significance of nuchal translucency in Japan[J].J Hum Genet,2008,53(8):688-693.
[3] WESTIN M,SALTVEDT S,ALMSTROM H,et al.By how much does increased nuchal translucency increase the risk of adverse pregnancy outcome in chromosomally normal fetuses?A study of 16260fetuses derived from an unselected pregnant population[J].Ultrasound Obstet Gynecol,2007,29(2):150-158.
[4] KAGAN K O,AVGIDOU K,MOLINA F S,et al.Relation between increased fetal nuchal translucency thickness and chromosomal defects[J].Obstet Gynecol,2006,107(1):6-10.
[5]王莉,吴青青,陈焰,等.标准化超声切面筛查孕11~13+6周胎儿结构畸形的临床意义[J/OL].中华医学超声杂志:电子版,2014,11(1):25-31.
[6]裴秋艳,张晓红,李建国,等.胎儿颈项透明层增厚及静脉导管血流频谱异常在先天性心脏畸形筛查中的价值[J].中国超声医学杂志,2011,27(2):169-172.
[7] AKSAM S,PLESINAC S,DOTLIC J,et al.First trimester ultrasonographic parameters in prediction of the course and outcome of monochorionic twin pregnancies[J].Turk J Med Sci,2017,47(3):934-941.