Rembouskos G, Cicero S, Papadopoulos V, Tripsanas C, Nicolaides K H
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, London, UK.
Ultrasound Obstet Gynecol. 2004 Mar;23(3):237-9. doi: 10.1002/uog.969.
To determine the potential value of measuring umbilical cord diameter (UCD) at 11-14 weeks of gestation in screening for chromosomal defects.
The UCD was measured in 1323 fetuses immediately before chorionic villus sampling for karyotyping at 11-14 weeks of gestation. In the group of chromosomally normal fetuses, regression analysis was used to determine the association between UCD and crown-rump length (CRL). UCD was compared in normal fetuses and those with chromosomal abnormalities.
The median gestation was 12 (range, 11-14) weeks. The UCD was successfully measured in all cases. The fetal karyotype was normal in 1150 pregnancies and abnormal in 173, including 97 cases of trisomy 21. In the chromosomally normal group the UCD increased significantly with CRL from a mean of 2.9 mm at a CRL of 45 mm to 4.4 mm at a CRL of 84 mm. The UCD in the group of fetuses with trisomy 21 was significantly smaller than normal. Conversely, there were no significant differences from normal in the UCD of fetuses with other chromosomal abnormalities.
At 11-14 weeks of gestation the UCD of fetuses with trisomy 21 is significantly smaller than normal but the magnitude of the difference is too small for useful inclusion of this measurement in screening.
确定在孕11 - 14周测量脐带直径（UCD）对染色体缺陷筛查的潜在价值。
在1323例胎儿孕11 - 14周进行绒毛取样进行核型分析前立即测量其UCD。在染色体正常胎儿组中，采用回归分析确定UCD与顶臀长（CRL）之间的关联。比较正常胎儿与染色体异常胎儿的UCD。
中位孕周为12（范围11 - 14）周。所有病例均成功测量了UCD。1150例妊娠胎儿核型正常，173例异常，其中21三体97例。在染色体正常组中，UCD随CRL显著增加，CRL为45 mm时平均为2.9 mm，CRL为84 mm时为4.4 mm。21三体胎儿组的UCD明显小于正常胎儿。相反，其他染色体异常胎儿的UCD与正常胎儿无显著差异。
孕11 - 14周时，21三体胎儿的UCD明显小于正常胎儿，但差异幅度太小，无法将该测量值有效纳入筛查。
