定量和定性静脉导管血流评估在 18 三体和 13 三体筛查中的应用——适宜性研究。

Quantitative and qualitative Ductus Venosus blood flow evaluation in the screening for Trisomy 18 and 13 - suitability study.

机构信息

Department of Obstetrics and Gynecology in Ruda Slaska, Medical University of Silesia, Ruda Slaska, Poland.

Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Faculty of Health Sciences, Department of Obstetrics, Bydgoszcz, Poland.

出版信息

Ginekol Pol. 2020;91(3):144-148. doi: 10.5603/GP.2020.0031.

DOI:10.5603/GP.2020.0031

PMID:32266955

Abstract

OBJECTIVES

The objective of the paper is the suitability assessment of screening for Trisomy 18 and 13 on the basis of nuchal translucency (NT) measurement, Fetal Heart Rate (FHR), double test, quantitative [Ductus Venosus (DV) Pulsatility Index for Veins (PIV)] and qualitative (the A-wave assessment) blood flow evaluation in the DV.

MATERIAL AND METHODS

The study was performed in 7296 singleton pregnancies. In each fetus NT, FHR, DV-PIV were examined. Double test from maternal blood was examined. These ultrasound and biochemical factors were in combined screening investigated. Additional doppler ultrasound markers such as abnormal a-wave in Ductus Venosus and Pusatility Index for Veins of Ductus Venosus were and their impact on Trisomies 18 and 13 screening were examined.

RESULTS

Two groups of patients were compared - with chromosomal normal and chromosomal abnormalities - Trisomy 18 and 13. Detection Rate of Trisomies 18 and 13 at the risk cutoff 1/300 using combined screening was 90.2% and FPR was 6%. Detection Rates of examined chromosomal abnormalities using contingent screening were: 92.1% using DV abnormal a-wave and 94.84% using DV-PIV. FPR's for booths parameters 5.8% and 5.4% respectively.

CONCLUSIONS

Quantitative analysis of the flow - assessment of DV-PIV in the first trimester significantly influences the improvement of screening values focusing on Trisomy 18 and 13 detection.

摘要

目的

本文旨在评估基于颈项透明层（NT）测量、胎儿心率（FHR）、双重检测、定量[静脉导管（DV）搏动指数（PIV）]和定性（A 波评估）血流评估的 DV 中筛查 18 三体和 13 三体的适用性。

材料与方法

本研究共纳入 7296 例单胎妊娠。在每个胎儿中均进行了 NT、FHR 和 DV-PIV 检查。还对来自母体血液的双重检测进行了检查。对这些超声和生化因素进行了联合筛查研究。检查了静脉导管中的异常 A 波和静脉导管搏动指数等其他多普勒超声标志物及其对 18 三体和 13 三体筛查的影响。

结果

比较了两组患者，一组为染色体正常，另一组为染色体异常（18 三体和 13 三体）。在风险截止值为 1/300 时，使用联合筛查检测 18 三体和 13 三体的检出率为 90.2%，假阳性率为 6%。使用 contingent screening 检测到的异常染色体的检出率分别为：DV 异常 A 波为 92.1%，DV-PIV 为 94.84%。两个参数的假阳性率分别为 5.8%和 5.4%。