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孕中期超声检查发现孤立性胎儿股骨和肱骨短小的整倍体妊娠不良结局的风险

Risk of Adverse Outcomes in Euploid Pregnancies With Isolated Short Fetal Femur and Humerus on Second-Trimester Sonography.

作者信息

Kaijomaa Marja, Ulander Veli-Matti, Ryynanen Markku, Stefanovic Vedran

机构信息

Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland

Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.

出版信息

J Ultrasound Med. 2016 Dec;35(12):2675-2680. doi: 10.7863/ultra.16.01086.

Abstract

OBJECTIVES

The purpose of this study was to evaluate pregnancies with isolated short fetal femur and humerus on second-trimester sonography. Short fetal long bones are known to be associated with aneuploidy and structural anomalies. In this study, we wanted to show the risk of adverse pregnancy outcomes in euploid and nonanomalous pregnancies.

METHODS

Singleton pregnancies with short femur and humerus were included. Pregnancies with normal fetal bone lengths and age-matched mothers were selected as controls.

RESULTS

The study group included 30 pregnancies with short fetal femur and humerus, and the control group included 60 normal pregnancies. The overall odds ratio for an adverse pregnancy outcome in the study group was 24.9. Preterm delivery occurred significantly more frequently (odds ratio, 20.8; P < .001), and one-third of pregnancies were complicated by preeclampsia. In the group with short long bones, the odds ratio for a pathologic umbilical Doppler flow pattern was 45.2 (P < .001), and birth weight was significantly lower (P < .001). Also, 3 (10.3%) stillbirths and 4 (13.3%) cases of early neonatal death were recorded in this group. These complications were not recorded in the control group. The risk of emergency cesarean delivery was significantly higher in the group with short long bones (odds ratio, 11.8; P < .001).

CONCLUSIONS

The risk of adverse pregnancy outcomes is significant in euploid and nonanomalous pregnancies with isolated short long bones. Close follow-up is needed during pregnancy.

摘要

目的

本研究旨在评估孕中期超声检查发现孤立性胎儿股骨和肱骨短小的妊娠情况。已知胎儿长骨短小与非整倍体及结构异常有关。在本研究中,我们想展示整倍体且无异常的妊娠中不良妊娠结局的风险。

方法

纳入单胎妊娠且股骨和肱骨短小的病例。选取胎儿骨长度正常且母亲年龄匹配的妊娠作为对照。

结果

研究组包括30例胎儿股骨和肱骨短小的妊娠,对照组包括60例正常妊娠。研究组不良妊娠结局的总体比值比为24.9。早产发生频率显著更高(比值比,20.8;P <.001),且三分之一的妊娠并发子痫前期。在长骨短小的组中,病理性脐动脉多普勒血流模式的比值比为45.2(P <.001),出生体重显著更低(P <.001)。此外,该组记录到3例(10.3%)死产和4例(13.3%)早期新生儿死亡。对照组未记录到这些并发症。长骨短小的组急诊剖宫产的风险显著更高(比值比,11.8;P <.001)。

结论

在整倍体且无异常、仅有长骨短小的妊娠中,不良妊娠结局的风险显著。孕期需要密切随访。

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