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伴有和不伴有孤立性和非孤立性右锁骨下动脉异常的胎儿相关的先天性异常和遗传异常。

Associated congenital anomalies and genetic anomalies in fetuses with isolated and non-isolated aberrant right subclavian artery.

机构信息

Department of Ultrasonics, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.

Department of Ultrasonics, Chongqing Health Center for Women and Children, Chongqing, China.

出版信息

J Matern Fetal Neonatal Med. 2023 Dec;36(1):2211705. doi: 10.1080/14767058.2023.2211705.

Abstract

OBJECTIVE

This study's aim was to determine the prevalence of chromosomal anomalies in fetuses with isolated and non-isolated aberrant right subclavian artery (ARSA) and to evaluate its association with other congenital anomalies.

METHODS

From September 2018 to October 2021, 668 ARSA cases were diagnosed by prenatal ultrasound in our hospital; cases with missed visits and a lack of chromosomal findings were excluded and 363 cases were eligible for enrollment. General information, ultrasound presentation, chromosomal findings and pregnancy outcomes were retrospectively analyzed.

RESULTS

Among the 363 cases, 296 were isolated, and 67 were associated with structural abnormalities or soft marker abnormalities. The proportion of fetuses with chromosomal abnormalities in the isolated ARSA group was significantly lower than that in the non-isolated ARSA group ( < .001). In the non-isolated ARSA group, 22 cases were combined with other soft marker abnormalities and 45 cases were combined with structural abnormalities. The most frequent structural abnormality coexisting with ARSA was cardiac malformations (38.81%).

CONCLUSION

The most common combined malformation in ARSA is intracardiac malformation. Isolated ARSA has a low risk of chromosomal abnormalities, so invasive chromosomal testing is not recommended. Non-isolated ARSA has a high incidence of chromosomal abnormalities, so early karyotyping should be recommended.

摘要

目的

本研究旨在确定孤立性和非孤立性右锁骨下动脉异常(ARSA)胎儿的染色体异常发生率,并评估其与其他先天性异常的关系。

方法

2018 年 9 月至 2021 年 10 月,我院经产前超声诊断出 668 例 ARSA 病例;排除失访和染色体结果缺失的病例,有 363 例符合入组条件。回顾性分析一般资料、超声表现、染色体结果和妊娠结局。

结果

363 例中,296 例为孤立性,67 例与结构异常或软标记异常有关。孤立性 ARSA 组胎儿染色体异常的比例明显低于非孤立性 ARSA 组(<0.001)。在非孤立性 ARSA 组中,22 例合并其他软标记异常,45 例合并结构异常。最常见的与 ARSA 并存的结构异常是心脏畸形(38.81%)。

结论

ARSA 最常见的合并畸形是心内畸形。孤立性 ARSA 染色体异常风险较低,不建议进行有创性染色体检测。非孤立性 ARSA 染色体异常发生率较高,因此建议早期行核型分析。

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