孕早期胎儿颈项透明层厚度筛查在ART出生缺陷检出中的重要性  

The Importance of Fetal Nuchal Translucency Thickness Screening during their First-trimester on Birth Defects among Pregnancies Conceived by Assisted Reproductive Technology

作　　者：赵君利[1,2] 刘满梅[1] 杜娟[1] 刘丹[1] 王海燕[1] 单翠萍[1] 姜银芝[1,2] 徐仙[1,2] 哈灵侠[1,2] 胡蓉[1,2] 

机构地区：[1]宁夏医科大学总医院,银川750004 [2]宁夏回族自治区生殖与遗传重点实验室,宁夏医科大学生育力保持教育部重点实验室,银川750004

出　　处：《宁夏医科大学学报》2014年第4期386-390,共5页Journal of Ningxia Medical University

基　　金：宁夏回族自治区留学人员创新创业择优资助个人项目;卫生行业科研专项(201002013)

摘　　要：目的探讨对辅助生殖技术(assisted reproductive technology,ART)妊娠群体加强孕早期超声胎儿颈项透明层(nuchal translucency,NT)厚度筛查的必要性和重要性。方法报道我中心体外受精/卵胞浆内单精子注射/冻融胚胎移植技术(IVF/ICSI/FET)妊娠子代出生缺陷及一组行前瞻性孕早期超声NT筛查结果及其子代出生缺陷情况,比较其与未行NT筛查的IVF/ICSI/FET子代出生缺陷检出时间及特点。结果①1845个IVF/ICSI/FET移植周期检出子代出生缺陷者15例,共18个出生缺陷儿;其中单胎妊娠占10例有10个出生缺陷儿,双胎占5例有8个出生缺陷儿,双胎妊娠出生缺陷儿占总出生缺陷儿的44.44%(8/18)。②112例(138个胎儿)接受NT筛查,单胎86例,双胎26例(52个胎儿),检出NT异常2例(单双胎各1例),子代畸形3例(单胎2例,双胎1例)。③早孕、中孕、晚孕期/出生后确诊子代畸形者NT筛查组分别为1、2、0例,未行NT筛查组分别为0、3、9例,子代出生缺陷的检出时间NT筛查组显著早于未行NT筛查组(χ2=7.50,P<0.05)。结论 ART群体子代出生缺陷率和多胎率高,NT筛查有利于较早发现并杜绝子代出生缺陷儿出生,应重视不孕症患者ART助孕后的孕早期超声筛查。Objective To investigate the necessity and importance of fetal nuchal translucency thickness （NT） screening during the first trimester among pregnancies conceived by assisted reproductive technology （ART）,Methods Details of all birth defects among pregnancies conceived by IVF/ICSI/FET in our center were reported.NT was measured prospectively during the first trimester among one group of pregnancies by IVF/ICSI/FET from Jan 2012 to Dec 2013.The characters of birth defects between groups with and without NT screening were compared.Results ①15 cases （18 fetus） with birth defects were found among 1845 em bryo transfer cycles since IVF/ICSI/FET had performed in our center,among them there were 10 case of singleton and 5 cases （8 fetus） of twin pregnancies [44.44 % （8/18）] ; ②112 cases （138 fetus） which included 86 singleton and 26 twin （52 fetus） were screened for NT during their 11 ～ 13 ＋6 gestational weeks.2 cases with abnormal NT and 3 cases of birth defects were found among them ; ③1 case,2 cases and 0 case birth defects were diagnosed during their first,second and third trimester in NT screening group;while in group without NT screening,0 case,3 case and 9 cases birth defects were diagnosed during their first,second and third trimester.Birth defects were diagnosed more earlier in group with NT screening than those in group without NT screening（x2 =7.50,P 〈 0.05）.Conclusion The rates of birth defects and multiple pregnancy are high among pregnancies conceived by ART.NT screening is effective to detect abnormal fetus at earlier pregnant age.It should be pay more attention during their first trimester.

关 键 词：颈项透明层 辅助生殖技术 出生缺陷 

分 类 号：R714.53[医药卫生—妇产科学]