Monni G, Zoppi M A, Ibba R M, Putzolu M, Floris M
Department of Obstetrics and Gynecology, Prenatal and Preimplantation Genetic Diagnosis, Fetal Therapy, Ospedale Regionale per le Microcitemie, Via Jenner 09121 Cagliari, Italy.
Croat Med J. 2000 Sep;41(3):266-9.
To evaluate the prevalence of increased nuchal translucency (NT) in multiple pregnancies and its relation to fetal karyotype and pregnancy outcome.
We measured fetal nuchal translucency (NT) in 6,338 women pregnant from 10+3 to 13+6 weeks by ultrasound and evaluated the prevalence of NT=95th centile in 115 multiple pregnancies, including 100 pairs of twins (70 dichorionic and 30 monochorionic placentas), 9 triplets, 5 quadruplets, and one quintuplet. Chorionicity, fetal karyotype, and pregnancy outcome were also evaluated in 400 singleton pregnancies.
NT=95th centile in a single fetus was found in 10/70 cases of dichorionic twin pregnancies (14%), in two quadruplets, in 7/30 monochorionic twin pregnancies (23.3%), and in both fetuses in one dichorionic twin pregnancy. In the control group, NT=95th centile was found in 17/400 (4.2%) cases. In multiple pregnancies, two cases of trisomy 21 and one of 47, XXY were found. NT=95th centile was found in 2/2 fetuses with trisomy 21 (one dichorionic twin pregnancy and one tetrachorionic pregnancy), but not in the 47, XXY trisomy (trichorionic triplet pregnancy). A skeletal dysplasia and a Goldenhar syndrome were found among the 10 dichorionic pregnancies with increased NT. Three intrauterine deaths of both fetuses, one congenital heart disease, and a case of twin-to-twin transfusion occurred in 7 monochorionic pregnancies with increased NT.
Increased NT in multiple pregnancies indicates fetuses at risk of chromosomal abnormalities and fetal malformation, and monochorionic twin pregnancies at higher risk of adverse outcome.
评估多胎妊娠中颈部透明带（NT）增厚的发生率及其与胎儿核型和妊娠结局的关系。
我们对6338例孕10⁺³至13⁺⁶周的孕妇进行超声测量胎儿颈部透明带（NT），并评估115例多胎妊娠中NT值处于第95百分位数的发生率，其中包括100对双胞胎（70例双绒毛膜和30例单绒毛膜胎盘）、9例三胞胎、5例四胞胎和1例五胞胎。同时对400例单胎妊娠的绒毛膜性、胎儿核型和妊娠结局也进行了评估。
在双绒毛膜双胎妊娠的70例中，有10例（14%）单胎胎儿NT值处于第95百分位数；在2例四胞胎中；在单绒毛膜双胎妊娠的30例中有7例（23.3%）单胎胎儿NT值处于第95百分位数；在1例双绒毛膜双胎妊娠中两个胎儿NT值均处于第95百分位数。在对照组中，400例中有17例（4.2%）NT值处于第95百分位数。在多胎妊娠中，发现2例21三体和1例47, XXY。2例21三体胎儿（1例双绒毛膜双胎妊娠和1例四绒毛膜妊娠）NT值处于第95百分位数，但47, XXY三体（三绒毛膜三胎妊娠）胎儿NT值未处于第95百分位数。在10例NT增厚的双绒毛膜妊娠中发现1例骨骼发育异常和1例Goldenhar综合征。在7例NT增厚的单绒毛膜妊娠中发生了3例双胎均宫内死亡、1例先天性心脏病和1例双胎输血综合征。
多胎妊娠中NT增厚提示胎儿有染色体异常和胎儿畸形的风险，单绒毛膜双胎妊娠不良结局风险更高。
