孕11⁺⁰至13⁺⁶周染色体异常胎儿的躯干和头部体积

Fetal trunk and head volume in chromosomally abnormal fetuses at 11+0 to 13+6 weeks of gestation.

作者信息

Falcon O, Peralta C F A, Cavoretto P, Auer M, Nicolaides K H

机构信息

Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, London, UK.

出版信息

Ultrasound Obstet Gynecol. 2005 Oct;26(5):517-20. doi: 10.1002/uog.1990.

DOI:10.1002/uog.1990

PMID:16142826

Abstract

OBJECTIVE

To examine the pattern of growth in chromosomally abnormal fetuses at 11+0 to 13+6 weeks of gestation and compare the trunk and head volume to crown-rump length (CRL) in defining the growth deficit in such fetuses.

METHODS

The fetal trunk and head volume was measured using three-dimensional (3D) ultrasound in 140 chromosomally abnormal fetuses at 11+0 to 13+6 (median 12) weeks of gestation, and the values were compared to 500 chromosomally normal fetuses. In each chromosomally abnormal fetus, the observed fetal trunk and head volume was subtracted from the expected mean (delta value) of the chromosomally normal fetuses of the same gestational age, and this difference was expressed as a percentage of the appropriate normal mean. The Mann-Whitney U-test was used to determine the significance of differences between the chromosomally normal and abnormal groups.

RESULTS

In trisomy 21 (n=72) and Turner syndrome (n=14) fetuses, compared to chromosomally normal fetuses, the CRL for gestation was similar (P=0.335 and P=0.317, respectively), but the fetal trunk and head volume was about 10-15% lower (P<0.001 and P=0.004, respectively). In trisomy 18 (n=29), trisomy 13 (n=14) and triploidy (n=11), the deficit in volume was about 45% (P<0.001), whereas the deficit in CRL was less than 15% (P<0.001).

CONCLUSIONS

In the quantification of the degree of early growth impairment in chromosomally abnormal fetuses, measurement of the fetal trunk and head volume using 3D ultrasound may be better than measurement of CRL.

摘要

目的

研究孕11⁺⁰至13⁺⁶周染色体异常胎儿的生长模式，并比较躯干和头部体积与顶臀长（CRL），以确定此类胎儿的生长缺陷。

方法

在孕11⁺⁰至13⁺⁶（中位值12）周时，使用三维（3D）超声测量140例染色体异常胎儿的胎儿躯干和头部体积，并将这些值与500例染色体正常胎儿进行比较。在每个染色体异常胎儿中，从相同孕周染色体正常胎儿的预期平均值（差值）中减去观察到的胎儿躯干和头部体积，该差异表示为相应正常平均值的百分比。采用曼-惠特尼U检验确定染色体正常组与异常组之间差异的显著性。

结果

在21三体（n = 72）和特纳综合征（n = 14）胎儿中，与染色体正常胎儿相比，孕周对应的CRL相似（分别为P = 0.335和P = 0.317），但胎儿躯干和头部体积约低10 - 15%（分别为P < 0.001和P = 0.004）。在18三体（n = 29）、13三体（n = 14）和三倍体（n = 11）中，体积缺陷约为45%（P < 0.001），而CRL缺陷小于15%（P < 0.001）。