Centre Hospitalo-Universitaire (CHU) Necker-Enfants Malades, AP-HP, Université Paris Descartes, Paris, France.
Am J Obstet Gynecol. 2012 Oct;207(4):306.e1-5. doi: 10.1016/j.ajog.2012.05.014. Epub 2012 May 18.
Prenatal screening for aneuploidies is best achieved in the first trimester when there is no reliable screening test for spina bifida. Early ultrasound features may be too complex for routine screening. We assessed screening potential of simple and reproducible fetal biometric measurements at 11-14 weeks of gestation.
A total of 34,951 unselected consecutive pregnancies included 18 with spina bifida. Another 28 cases were referred for assessment. Biometric measurements were expressed in multiples of the median for crown-rump length.
Biparietal diameter (BPD) was smaller in spina bifida (P < .0001). In all, 22 of 44 (50%) cases with spina bifida aperta had a BPD <5th centile. BPD was independent of maternal adiposity and smoking status.
Simple and reproducible BPD at 11-14 weeks of gestation could detect half the cases of open fetal spina bifida by identifying 5% of pregnancies for expert scanning in first- and second-trimester examinations of the fetal spine and cranium.
在孕早期，尚无可靠的脊柱裂筛查方法，因此进行非整倍体筛查效果最佳。早期超声特征可能过于复杂，不适合常规筛查。我们评估了 11-14 孕周时简单且可重复的胎儿生物测量指标的筛查潜力。
共纳入 34951 例未经选择的连续妊娠，其中 18 例为脊柱裂。另外还有 28 例因评估而纳入。生物测量指标以头臀长的中位数倍数表示。
脊柱裂组的双顶径（BPD）较小（P<0.0001）。在所有开放性脊柱裂病例中，22 例（50%）的 BPD<第 5 百分位数。BPD 不受母亲肥胖和吸烟状况的影响。
11-14 孕周时简单且可重复的 BPD 可通过识别出 5%的妊娠情况，使一半的开放性胎儿脊柱裂病例被检出，这些妊娠需要在早、中孕期对胎儿脊柱和颅骨进行专家扫描。
