Physician in Prenatal Medicine, Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam.
Senior Researcher, Naturalis Biodiversity Center, Leiden.
Obstet Gynecol Surv. 2016 Dec;71(12):741-750. doi: 10.1097/OGX.0000000000000388.
The human vertebral column has a stable number of vertebrae and ribs, which is presumably the result of evolutionary selection. An association between an abnormal vertebral pattern, especially in the cervical region, and congenital anomalies or adverse fetal outcome has been reported.
The aim of this study was to review the current literature concerning an abnormal vertebral pattern and prevalence of cervical ribs in healthy subjects and in subjects with adverse outcome.
Scientific databases were searched systematically. Studies assessing the number of vertebrae and/or ribs were included, and data concerning anomalies and outcome were extracted.
Thirty-nine studies including 75,018 healthy subjects and 6130 subjects with structural or chromosomal anomalies or adverse outcome were selected. The majority of these studies focused on the prevalence of cervical ribs. The prevalence of cervical ribs was considerably higher in fetuses with adverse outcome, including aneuploidies, compared with healthy individuals in the vast majority of studies. Studies suggest an association between cervical ribs and other structural anomalies.
These results demonstrate that detailed assessment of the fetal vertebral column, especially of the cervicothoracic region, could provide valuable information regarding fetal and neonatal prognosis. Based on the available evidence, the application of 3-dimensional (3D) ultrasound to assess the vertebral column and ribs, in particular the cervical region, warrants further research.
Prenatal assessment of the ribs and vertebral pattern by 3D ultrasound, which is currently not routinely performed, might be useful in the assessment of the fetus, because this can predict fetal and neonatal outcome in some cases.
人类的脊柱有一个稳定的椎骨和肋骨数量，这大概是进化选择的结果。据报道，异常的脊柱模式，尤其是在颈椎区域，与先天性异常或不良胎儿结局之间存在关联。
本研究旨在回顾当前关于异常椎骨模式和颈椎肋骨在健康受试者和不良结局受试者中的发生率的文献。
系统地搜索了科学数据库。纳入了评估椎骨和/或肋骨数量的研究，并提取了有关异常和结局的数据。
选择了 39 项研究，其中包括 75018 名健康受试者和 6130 名结构或染色体异常或不良结局的受试者。这些研究大多集中在颈椎肋骨的发生率上。在大多数研究中，与健康个体相比，具有不良结局的胎儿，包括非整倍体，其颈椎肋骨的发生率明显更高。研究表明颈椎肋骨与其他结构异常之间存在关联。
这些结果表明，详细评估胎儿的脊柱，特别是颈胸区域，可能为胎儿和新生儿的预后提供有价值的信息。基于现有证据，应用 3 维（3D）超声评估脊柱和肋骨，特别是颈椎区域，值得进一步研究。
目前未常规进行的 3D 超声对肋骨和椎骨模式的产前评估可能对胎儿评估有用，因为在某些情况下可以预测胎儿和新生儿的结局。
