Şahin Uysal Nihal, Gülümser Çağrı, Yılmaz Çelik Zerrin, Yanık Filiz Bilgin
Başkent University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey.
Başkent University Faculty of Medicine, Department of Medical Genetics, Ankara, Turkey.
Turk J Obstet Gynecol. 2019 Jun;16(2):100-106. doi: 10.4274/tjod.galenos.2019.51482. Epub 2019 Jul 3.
First trimester nuchal translucency (NT) measurement is considered to be an important tool in antenatal follow-up. This study aimed to evaluate the outcomes of pregnancies with increased NT at Başkent University Ankara Hospital between 2004 and 2016.
Patients with NT measurements ≥1.5 multiples of median (MoM) were divided into two groups; group I included increased NT cases without fetal anomalies (either abnormal fetal karyotype or congenital structural anomalies) or loss (intrauterine fetal death), and group II included increased NT cases with fetal anomalies or loss. The groups were compared with each other with respect to maternal demographic features and NT measurements.
Karyotype analyses were normal in 73.1% of cases with increased NT (57/78). Among those, 21.1% (12/57) had structural anomalies, and to specify, 9.6% (5/52 over 18 weeks) had cardiac anomalies. Although maternal demographic features did not differ significantly, NT measurements, both as millimeters and MoM, were significantly higher in group II (p<0.05). According to the receiver operating characteristic (ROC) curves, the optimal cut-off values for NT measurements for predicting fetal anomalies or loss were 3.05 mm and 2.02 MoM. NT measurement >7 millimeters or NT MoM >4.27 resulted in poor fetal outcomes without exception.
Higher NT measurements indicate poorer pregnancy outcomes. Our study indicates that fetal echocardiography must be considered for all cases with increased NT.
孕早期颈项透明层（NT）测量被认为是产前随访的一项重要工具。本研究旨在评估2004年至2016年期间在安卡拉巴什肯特大学医院NT值升高的妊娠结局。
NT测量值≥1.5中位数倍数（MoM）的患者被分为两组；第一组包括NT值升高但无胎儿异常（胎儿核型异常或先天性结构异常）或妊娠丢失（宫内胎儿死亡）的病例，第二组包括NT值升高且伴有胎儿异常或妊娠丢失的病例。比较两组患者的母亲人口统计学特征和NT测量值。
NT值升高的病例中，73.1%（57/78）的核型分析正常。其中，21.1%（12/57）有结构异常，具体而言，9.6%（18周以上的5/52）有心脏异常。尽管母亲人口统计学特征无显著差异，但第二组的NT测量值（以毫米和MoM为单位）均显著更高（p<0.05）。根据受试者操作特征（ROC）曲线，预测胎儿异常或妊娠丢失的NT测量最佳截断值为3.05毫米和2.02 MoM。NT测量值>7毫米或NT MoM>4.27无一例外导致不良胎儿结局。
NT测量值越高，妊娠结局越差。我们的研究表明，对于所有NT值升高的病例都必须考虑进行胎儿超声心动图检查。
