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产前诊断后 13 三体、18 三体和三倍体的自然结局。

Natural outcome of trisomy 13, trisomy 18, and triploidy after prenatal diagnosis.

机构信息

Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.

出版信息

Am J Med Genet A. 2011 Nov;155A(11):2626-33. doi: 10.1002/ajmg.a.34284. Epub 2011 Oct 11.

Abstract

Trisomy 13, trisomy 18, and triploidy belong to the chromosomal abnormalities which are compatible with life, but which are also associated with a high rate of spontaneous abortion, intrauterine death, and a short life span. This study was conducted to analyze natural outcome after prenatal diagnosis of these disorders. Between January 1, 1999 and December 31, 2009, we investigated all amniocenteses and chorionic villus biopsies carried out at our department. All cases with fetal diagnosis of triploidy, trisomy 13, and 18 were analyzed, with a focus on cases with natural outcome. Overall, 83 (78%) cases of pregnancy termination and 24 (22%) patients with natural outcome (NO) were identified. The NO group included 15 cases of trisomy 18, six cases of triploidy, and three cases of trisomy 13. No case of triploidy was born alive. The live birth rate was 13% for trisomy 18 and 33% for trisomy 13. The three live-born infants with trisomy 13 and 18 died early after a maximum of 87 hr postpartum. Our data are consistent with the literature concerning outcome of triploidy, with none or only a few live births. Analyzes of trisomy 13 and 18 indicate a very short postnatal life span. Different study designs and diverse treatment strategies greatly affect the fetal and neonatal outcome of fetuses with triploidy, trisomy 13, and 18. More studies analyzing natural outcome after prenatal diagnosis of these chromosomal abnormalities are needed. Non-termination of these pregnancies remains an option, and specialists advising parents need accurate data for counseling.

摘要

三体 13、三体 18 和三倍体属于染色体异常,这些异常虽然可以存活,但与较高的自发性流产、宫内死亡和寿命短有关。本研究旨在分析产前诊断这些异常后的自然结局。1999 年 1 月 1 日至 2009 年 12 月 31 日期间,我们对我院进行的所有羊膜穿刺术和绒毛活检进行了调查。分析了所有胎儿诊断为三倍体、三体 13 和 18 的病例,重点分析了自然结局的病例。共有 83 例(78%)妊娠终止,24 例(22%)自然结局(NO)。NO 组包括 15 例三体 18、6 例三倍体和 3 例三体 13。没有三倍体活产。三体 18 的活产率为 13%,三体 13 的活产率为 33%。3 例三体 13 和 18 的活产婴儿在产后最多 87 小时后早期死亡。我们的数据与有关三倍体、无活产或仅有少数活产的文献一致。对三体 13 和 18 的分析表明,新生儿的存活时间极短。不同的研究设计和多样化的治疗策略极大地影响了三倍体、三体 13 和 18 胎儿的胎儿和新生儿结局。需要更多的研究来分析这些染色体异常产前诊断后的自然结局。继续妊娠仍然是一种选择,为父母提供咨询的专家需要准确的数据。

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