L'Herminé-Coulomb A
Service d'Anatomie Pathologique, Hôpital Antoine Béclère, 157, rue de la Porte-de-Trivaux, 92141 Clamart Cedex.
J Gynecol Obstet Biol Reprod (Paris). 2005 Feb;34(1 Suppl):S89-96. doi: 10.1016/s0368-2315(05)82694-8.
Increased physiological nuchal translucency (NT) between 10 and 14 weeks of gestation is associated with chromosomal anomalies, mainly trisomy 21, developmental malformations and with normal fetus outcome. The aim of this study is to understand the cellular mechanisms leading to increased NT.
We examined five nuchal samples, a normal fetus from a fetal loss with a normal NT, a trisomy 21 fetus with an increased NT, two karyotypically normal fetuses with increased NT and a fetus with increased NT associated with an isolated cardiopathy. These morphological data were correlated with data from the literature.
The pathological mechanism of increased NT is a posterior median mesenchymal edema of the fetal neck. It is associated with bilateral distension of jugular lymphatic vessels.
Increased NT mechanisms are mainly related to a disturbance of embryonic lymphangiogenesis which might be a common denominator of the alteration of the composition of the extracellular matrix and of the cardiovascular and hemodynamic disorder. Nuchal morphological studies should be systematically performed to understand the mechanisms of increased NT.
妊娠10至14周时生理性颈部透明带（NT）增厚与染色体异常（主要是21三体）、发育畸形以及正常胎儿结局相关。本研究的目的是了解导致NT增厚的细胞机制。
我们检查了五个颈部样本，一个来自自然流产且NT正常的正常胎儿，一个NT增厚的21三体胎儿，两个核型正常但NT增厚的胎儿，以及一个NT增厚且伴有孤立性心脏病的胎儿。这些形态学数据与文献数据相关联。
NT增厚的病理机制是胎儿颈部后正中间质水肿。它与双侧颈淋巴管扩张有关。
NT增厚的机制主要与胚胎淋巴管生成紊乱有关，这可能是细胞外基质成分改变以及心血管和血液动力学紊乱的共同特征。应系统地进行颈部形态学研究以了解NT增厚的机制。
