Brady K, Polzin W J, Kopelman J N, Read J A
Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington.
Obstet Gynecol. 1992 Feb;79(2):234-8.
This prospective investigation was designed to assess the incidence of chromosomal abnormalities in patients with idiopathic polyhydramnios. Polyhydramnios was defined as 25 cm or greater in total vertical height in all four quadrants (amniotic fluid index) in any nonreferral patient (ie, primary care population) undergoing sonographic examination with a singleton pregnancy, normal fetal anatomical survey, normal glucose screening, and negative antibody screen. During the 2-year period from May 1, 1988 through April 30, 1990, 5038 gravidas delivered at Madigan Army Hospital Center. Unexplained polyhydramnios was detected sonographically in 125 patients, an incidence of 2.5%. After obtaining informed written consent, amniocentesis was performed in all patients. Within this group (N = 125), four chromosomal abnormalities (incidence of 3.2%) were detected. There were two trisomy 18 and two trisomy 21 fetuses. None of the four patients had maternal serum alpha-fetoprotein screening performed. The incidence of aneuploidy in patients with idiopathic polyhydramnios (3.2%) is much higher than the reported incidence of major karyotype abnormalities in live births (0.59%). We conclude that fetal chromosomal analysis should be considered in all obstetric patients with sonographic evidence of idiopathic polyhydramnios.
本前瞻性研究旨在评估特发性羊水过多患者染色体异常的发生率。羊水过多定义为在接受超声检查的任何非转诊患者（即初级保健人群）中，单胎妊娠、胎儿解剖结构检查正常、葡萄糖筛查正常且抗体筛查阴性的情况下，四个象限的总垂直深度（羊水指数）达到25厘米或更高。在1988年5月1日至1990年4月30日的两年期间，马迪根陆军医院中心有5038名孕妇分娩。超声检查发现125例患者原因不明的羊水过多，发生率为2.5%。在获得知情书面同意后，对所有患者进行了羊膜腔穿刺术。在这组患者（N = 125）中，检测到4例染色体异常（发生率为3.2%）。有2例18三体胎儿和2例21三体胎儿。这4例患者均未进行母血清甲胎蛋白筛查。特发性羊水过多患者的非整倍体发生率（3.2%）远高于活产中主要核型异常的报道发生率（0.59%）。我们得出结论，对于所有超声检查显示特发性羊水过多的产科患者，均应考虑进行胎儿染色体分析。
