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伴有软指标胎儿的结局:阿瓦士市3016例病例的结果

Outcome of fetuses with soft markers: results of 3016 cases in Ahvaz city.

作者信息

Masihi Sara, Barati Mojgan, Karimi Moghaddam Elham, Rezazadeh Afshin, Ronaghi Fatemeh

机构信息

Department of Obstetrics and Gynecology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Department of Radiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Med J Islam Repub Iran. 2021 Jan 7;35:4. doi: 10.47176/mjiri.35.4. eCollection 2021.

Abstract

Although soft markers may be seen as normal variants, they are important due to their association with chromosomal and congenital abnormalities. This cross-sectional descriptive-analytical study was done on 3016 women who referred for perinatal care. Fetuses with any of soft markers including thickened nuchal fold (TNF), mild pyelectasis (MP), choroid plexus cyst (CPC), single umbilical artery (SUA), mega cisterna magna (MCM) and mild ventriculomegaly (MVM) were followed during pregnancy and birth. Data analysis was carried out using SPSS for Windows (version 22). Data were analyzed using chi-square and T-test. A p-value <0.050 was considered statistically significant. 285 (9.4%) fetuses with soft markers Including 148 (4.9%) fetuses with CPC, 118 (3.9%) fetuses with MP, 2 (0.1%,) fetuses with isolated TNF, 8 (0.3%) fetuses with isolated MVM, 4 (0.13%) fetuses with SUA, 4 (0.13%) fetuses with MCM were identified, and one fetus had TNF and MVM simultaneously. In cases with CPC, no abortion or major structural abnormalities were observed and all 148 neonates had normal phenotypes at birth. Among 118 cases with MP, one case had a major cardiac disorder, and 2 cases of abortions (1.7%) were reported (p=0.481). 83 cases (70.3%) were male and 35 cases (29.7%) were female (p=0.021) and all neonates had a normal phenotype. Both pregnancies with isolated TNF resulted in abortion. Of the 8 cases with isolated MVM, two cases had major structural abnormalities. 2 cases of abortion were reported and all infants had a normal phenotype. In one case, that fetus had TNF and MVM simultaneously. Amniocentesis showed no aneuploidy. No major structural abnormalities were observed in fetuses with SUA. One case of abortion was reported. Among the three births, two pre-term births were reported, and all three infants had normal phenotype. In four cases with MCM, no major structural abnormality was observed and all four neonates had normal phenotype. In cases without association with other structural abnormality, mothers who have fetuses with CPC or MP should be reassured that the pregnancy outcomes are generally favorable.

摘要

尽管软指标可能被视为正常变异,但由于它们与染色体及先天性异常相关,所以很重要。本横断面描述性分析研究针对3016名前来接受围产期护理的女性进行。对有任何软指标的胎儿进行孕期及出生后的跟踪,这些软指标包括颈部透明带增厚(TNF)、轻度肾盂扩张(MP)、脉络丛囊肿(CPC)、单脐动脉(SUA)、巨大枕大池(MCM)和轻度脑室扩大(MVM)。使用SPSS for Windows(版本22)进行数据分析。采用卡方检验和T检验进行数据分析。p值<0.050被认为具有统计学意义。共识别出285例(9.4%)有软指标的胎儿,其中148例(4.9%)有CPC,118例(3.9%)有MP,2例(0.1%)有孤立性TNF,8例(0.3%)有孤立性MVM,4例(0.13%)有SUA,4例(0.13%)有MCM,1例胎儿同时有TNF和MVM。有CPC的病例中,未观察到流产或重大结构异常,所有148例新生儿出生时表型正常。118例有MP的病例中,1例有重大心脏疾病,报告了2例流产(1.7%)(p = 0.481)。83例(70.3%)为男性,35例(29.7%)为女性(p = 0.021),所有新生儿表型正常。2例孤立性TNF的妊娠均导致流产。8例孤立性MVM的病例中,2例有重大结构异常,报告了2例流产,所有婴儿表型正常。1例胎儿同时有TNF和MVM。羊水穿刺显示无染色体非整倍体。有SUA的胎儿未观察到重大结构异常,报告了1例流产。3例分娩中有2例早产,所有3例婴儿表型正常。4例有MCM的病例中,未观察到重大结构异常,所有4例新生儿表型正常。在与其他结构异常无关的情况下,有CPC或MP胎儿的母亲应得到安慰,妊娠结局通常良好。

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本文引用的文献

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Incidental Fetal Ultrasound Findings: Interpretation and Management.胎儿超声检查的偶然发现:解读与处理
J Midwifery Womens Health. 2018 May;63(3):323-329. doi: 10.1111/jmwh.12754. Epub 2018 May 15.
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Isolated single umbilical artery and fetal karyotype.孤立性单脐动脉与胎儿染色体核型。
Ultrasound Obstet Gynecol. 2010 Sep;36(3):291-5. doi: 10.1002/uog.7717.
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Isolated fetal pyelectasis and chromosomal abnormalities.
Am J Obstet Gynecol. 2005 Sep;193(3 Pt 1):732-8. doi: 10.1016/j.ajog.2005.02.074.
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RETIRED: Fetal soft markers in obstetric ultrasound.已退休:产科超声检查中的胎儿软指标。
J Obstet Gynaecol Can. 2005 Jun;27(6):592-636. doi: 10.1016/s1701-2163(16)30720-4.

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