Brumfield C G, Wenstrom K D, Davis R O, Owen J, Cosper P
Department of Obstetrics and Gynecology, University of Alabama at Birmingham, USA.
Obstet Gynecol. 1996 Dec;88(6):979-82. doi: 10.1016/s0029-7844(96)00358-4.
To compare karyotypic, ultrasonographic, and prognostic features of septated cystic hygromas and nonseptated cystic hygromas in second-trimester fetuses.
A computerized ultrasound data base was used to identify fetuses diagnosed with cystic hygromas at 14-22 weeks' gestation. Photographs from the initial ultrasound were reviewed retrospectively for hygroma type (septated or nonseptated) and any abnormal structural findings. Fetal karyotypes were obtained from amniotic fluid, aspiration of hygroma pouches, or fetal tissue culture. Pregnancy outcome information was obtained from hospital charts and physician office records. Ultrasound findings were then compared with fetal karyotype results and pregnancy outcome data.
From 1990 to 1995, 61 fetuses with cystic hygromas were identified. Karyotypes were obtained in 55 fetuses, and pregnancy outcome was available for 59. Abnormal karyotype was present in 42 of 55 fetuses (76%). The most common chromosomal abnormality in septated hygromas was the 45,X karyotype. Trisomy 21 was the most common chromosomal abnormality in nonseptated hygromas. Compared with fetuses with nonseptated cystic hygromas, those with septated cystic hygromas were more likely to be aneuploid (33 of 39 [85%] versus nine of 16 [56%]; P = .03), more likely to develop hydrops (27 of 45 [60%] versus three of 16 [19%]; P = .005), and less likely to be live-born (one of 44 [2%] versus four of 15 [27%]; P = .01).
Fetuses with septated cystic hygromas are more likely to be aneuploid and to develop hydrops, and thus are less likely to be survive than fetuses with nonseptated hygromas.
比较孕中期胎儿分隔性囊状水瘤与非分隔性囊状水瘤的核型、超声特征及预后特征。
利用计算机化超声数据库识别妊娠14 - 22周时诊断为囊状水瘤的胎儿。回顾性复查初次超声检查的照片，确定水瘤类型（分隔性或非分隔性）及任何异常结构发现。通过羊水、水瘤囊抽吸物或胎儿组织培养获取胎儿核型。从医院病历和医生办公室记录中获取妊娠结局信息。然后将超声检查结果与胎儿核型结果及妊娠结局数据进行比较。
1990年至1995年，共识别出61例患有囊状水瘤的胎儿。55例胎儿获得了核型结果，59例有妊娠结局信息。55例胎儿中有42例（76%）存在异常核型。分隔性水瘤最常见的染色体异常是45,X核型。21 - 三体是非分隔性水瘤最常见的染色体异常。与非分隔性囊状水瘤胎儿相比，分隔性囊状水瘤胎儿更易出现非整倍体（39例中的33例[85%] 对16例中的9例[56%]；P = 0.03），更易发生水肿（45例中的27例[60%] 对16例中的3例[19%]；P = 0.005），且活产可能性更低（44例中的1例[2%] 对15例中的4例[27%]；P = 0.01）。
与非分隔性水瘤胎儿相比，分隔性囊状水瘤胎儿更易出现非整倍体并发生水肿，因此存活可能性更低。
