Dane B, Dane C, Cetin A, Kiray M, Sivri D, Yayla M
Division of Perinatology, Department of Gynecology and Obstetrics, Haseki Training and Research Hospital, Istanbul, Turkey.
J Perinatol. 2008 Jun;28(6):400-4. doi: 10.1038/jp.2008.14. Epub 2008 Mar 13.
The aim of this study was to examine fetal and neonatal outcomes in the setting of nuchal translucency (NT) > or =3 mm at routine first-trimester screening.
A nested case-series study within a retrospective cohort of women screened for Down syndrome at 11-14 weeks of gestation. Crown-rump length, NT values and additional anomalies at first and early second trimesters were recorded. Follow-up information was obtained by a review of medical records and self-report from patients. Adverse outcomes included fetal death and termination of pregnancy due to structural or chromosomal anomalies.
A total of 1930 pregnant women were screened between 11 and 14 weeks of gestation. The prevalence of increased fetal NT (> or =3 mm) was 1.4% (n=27). Among these, 12 showed increased fetal NT as an isolated finding. In this group, 2 women experienced fetal demise (16%) and 10 delivered healthy babies. In the group with additional abnormalities (n=15), 9 (60%) were found to have chromosomal abnormalities, all of which were terminated. For all cases with increased fetal NT, total incidence of adverse outcome was 62%.
At first-trimester ultrasonography, a fetal NT > or =3 mm was associated with a high incidence of chromosomal abnormalities in the presence of associated abnormalities. For cases with the increased fetal NT at first-trimester fetal assessment and follow-up is necessary to detect possible adverse outcomes.
本研究旨在探讨在孕早期常规筛查时，颈部透明带（NT）≥3mm情况下的胎儿及新生儿结局。
在一项对妊娠11 - 14周进行唐氏综合征筛查的女性回顾性队列研究中进行嵌套病例系列研究。记录头臀长度、NT值以及孕早期和孕中期早期的其他异常情况。通过查阅病历和患者自我报告获取随访信息。不良结局包括因结构或染色体异常导致的胎儿死亡和终止妊娠。
共有1930名孕妇在妊娠11至14周期间接受了筛查。胎儿NT值升高（≥3mm）的患病率为1.4%（n = 27）。其中，12例仅表现为胎儿NT值升高。在这组中，2名女性发生了胎儿死亡（16%），10名分娩出健康婴儿。在伴有其他异常的组中（n = 15），9例（60%）被发现有染色体异常，所有这些病例均终止妊娠。对于所有胎儿NT值升高的病例，不良结局的总发生率为62%。
在孕早期超声检查中，当存在相关异常时，胎儿NT≥3mm与染色体异常的高发生率相关。对于孕早期胎儿评估时NT值升高的病例，有必要进行随访以检测可能的不良结局。
