Dombrowski M P, Berry S M, Isada N B, Jones T B, Evans M I
Department of Obstetrics and Gynecology, Hutzel Hospital/Wayne State University, Detroit, MI 48201.
Fetal Diagn Ther. 1993 Jan-Feb;8(1):10-4. doi: 10.1159/000263741.
There are limited data on the risks of aneuploidy for normal-appearing fetuses with amniotic fluid volume (AFV) abnormalities. The purpose of this study was to determine the relative risks of aneuploidy associated with second-trimester abnormal AFVs and fetal structural anomalies in a cohort of 2,823 singleton, viable fetuses. Compared to gravidas younger than 35 with normal ultrasounds, normal fetuses had an increased incidence of aneuploidy with polyhydramnios, increased AFV, i.e. subjectively increased but normal by maximum vertical pocket (MVP) and/or amniotic fluid index (AFI), oligohydramnios, and decreased AFV, i.e. subjectively decreased but normal by MVP and/or AFI. These included: increased AFV [odds ratio = 12.9, 95% confidence interval (CI) = 4.1-39.4], polyhydramnios (odds ratio = 4.6, CI = 0.6-36.8), and decreased AFV (odds ratio = 3.8, CI = 1.1-13.1). There were no aneuploidies among the 28 normal fetuses with oligohydramnios. Anomalous fetuses had a markedly increased incidence of aneuploidy (odds ratio = 13.4, CI = 7.2-24.9). We conclude that fetal structural anomalies as well as isolated AFV abnormalities were associated with an increased risk for aneuploidy.
关于羊水过少（AFV）异常但外观正常的胎儿非整倍体风险的数据有限。本研究的目的是确定在2823名单胎、存活胎儿队列中，与孕中期AFV异常和胎儿结构异常相关的非整倍体相对风险。与超声检查正常的35岁以下孕妇相比，正常胎儿出现羊水过多、AFV增加（即主观上增加但最大垂直羊水池（MVP）和/或羊水指数（AFI）正常）、羊水过少和AFV减少（即主观上减少但MVP和/或AFI正常）时，非整倍体发生率增加。这些情况包括：AFV增加[比值比=12.9，95%置信区间（CI）=4.1-39.4]、羊水过多（比值比=4.6，CI=0.6-36.8）和AFV减少（比值比=3.8，CI=1.1-13.1）。28例羊水过少的正常胎儿中未发现非整倍体。异常胎儿的非整倍体发生率显著增加（比值比=13.4，CI=7.2-24.9）。我们得出结论，胎儿结构异常以及孤立的AFV异常与非整倍体风险增加相关。
