孕早期胎儿颈部透明带增厚在产前诊断中价值与现状分析  

The evaluation of nuchal translucency abnormality in 115 cases

作　　者：谭春英[1] 戚红[1] 张爱青[1] 孟颖[1] 

机构地区：[1]北京市海淀区妇幼保健院产前筛查中心,北京100080

出　　处：《中国实用妇科与产科杂志》2012年第1期56-58,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨胎儿颈部透明带(NT)增厚对产前诊断的价值以及目前存在的问题。方法 2008年1月至2010年12月间在北京市海淀区妇幼保健院产前筛查门诊常规产检的单胎孕妇,在孕11～13+6周测量胎儿颈部透明带厚度,NT≥3mm视为异常,收集异常病例115例,随访至妊娠结束。结果在115例NT增厚的病例中,正常足月分娩54例,自然流产2例,医疗性中期引产59例。在54例正常分娩者中,NT值3.0～4.0mm 43例(79.63%),4.1～5.0mm 9例(16.67%),5.1～6.0mm 1例(1.85%),>6.0mm 1例(1.85%)。在115例NT增厚的病例中,单纯NT增厚者94例,产前诊断35例,产前诊断率37.23%(其中直接产前诊断30例,另有行血清学唐氏筛查高危而后行产前诊断者5例);同时合并其他器官异常者21例,其中心脏畸形6例(室间隔缺损2例,单心房2例,完全性心内膜垫缺损2例),器官积液6例,腹裂3例,单脐动脉2例,多发畸形4例。其中7例行产前诊断,产前诊断率33.33%,其他14例直接中期引产终止妊娠。42例产前诊断的病例中染色体正常25例(59.52%),染色体异常17例(40.48%),其中21-三体综合征11例,18-三体综合征4例,Turner综合征2例,21-三体综合征异常占64.71%。结论 NT增厚对于胎儿染色体疾病有重要的诊断价值,NT增厚提示胎儿畸形、流产、死胎的风险增加。NT的测量、后续诊断问题需要进一步规范,提高孕妇的依从性和产前诊断率。设立固定的NT切割值对于临床诊断和咨询是有意义的。Objective To evaluate the value of nuchal translucency （NT） in prenatal diagnosis of fetal chromosomal ab- normality and malformation. Methods Between Jan. 2008 and Dec. 2010 in the Beijing Haidian Maternal and Child Health Hospital,fetalNT and development in 115 cases of singleton pregnancy were detected to abnormal in 11 ~ 13 ＋6 weeks. Pregnancy outcomes of all women were followed up, and the NT I〉 3.0mm was abnormal. Results Normal deliv- ery, abortion, termination of midtrimester pregnancy,occurred in 54, 2, 59 in these 115 cases. Only with NT thickening there were 94 ones, in these people 35 ones underwent fetal karyotype analysis （37.23%）, severe malformation with NT thickening 21 ones, only 7 underwent fetal karyotype analysis （33.33%）. There are 42 ones underwent fetal karyotype analysis in 113 cases,Chromosomal normality is 25 eases（.59. 52% ）, chromosomal abnormality is 17 eases （40. 48% ）, trisomy 21, trisomy 18, Turner （45, X ） occurreff in 11, 4, and 2. Conclusion NT thickening may indicate the increased risk of fetal chromosomal abnormality, malformation, stillbirth and miscarriage. Through standard the value of NT and prenatal diagnosis to decrease the malformation. It was important to make a solid NT cutoff number for clinical consultation.

关 键 词：颈部透明带 妊娠 染色体核型 胎儿畸形. 

分 类 号：R714.53[医药卫生—妇产科学]