孕11～13^(+6)周NT增厚而染色体核型正常的胎儿孕期自然转归分析  

Analysis of Natural Outcome during Pregnancy at 11～13^(+6)Weeks of Gestation with NT Thickening and Normal Karyotype

作　　者：孙晶[1] 王丽[1] 望丹丹 谭卫荷[1] 

机构地区：[1]广东省清远市人民医院(广州医科大学附属第六医院),广东清远511518

出　　处：《中国医学创新》2017年第21期142-145,共4页Medical Innovation of China

摘　　要：目的:对早孕期颈项部皮肤透明层(Nuchal Translucency,NT)增厚(≥3.0 mm)的胎儿进行孕期及出生后追踪随访,了解及掌握中、晚孕期胎儿的发育情况,以期为临床产科医生提供科学的产前诊断策略。方法:2013年1月-2016年12月在本院产前诊断科完成早孕期单胎NT测量共计6533例,其中NT≥3.0 mm 299例,排除胎儿染色体异常病例68例,所有病例于孕16、24、36周进行超声复查及出生后随访。随访方式主要以病案追踪及电话随访为主,随访内容主要包括胎儿宫内发育情况及新生儿出生后健康状况。结果:299例NT≥3.0 mm的病例中,67例(22.4%)行产前诊断提示为染色体病。当排除染色体异常后,12.1%(21/174)的胎儿于孕16周前发现胎儿结构异常。孕24周前,有20.8%的胎儿发现结构异常。当孕期排除了胎儿染色体异常及超声结构畸形时,胎儿出生健康存活率为97.8%(90/92)。结论:胎儿NT增厚与染色体病及胎儿结构异常有明显的相关性,NT增厚不应作为胎儿终止妊娠的唯一指征。当孕期排除了胎儿染色体异常及超声结构异常时,胎儿出生后健康存活率较高。Objective： To follow up the gestation period and the post birth period of the fetus with nuchal translucency （ NT ） thickening is more than 3.0 mm, to understand and master the development of fetus during the middle and late pregnancy, it is expected to provide a scientific prenatal diagnosis strategy for clinical obstetricians. Method： From January 2013 to December 2016, NT measurement was performed for 6533 pregnancies, 299 cases were found to be with increased NT （ 33.0 mm）, 68 cases of fetal chromosomal abnormalities were excluded, fetuses were followed each pregnancy at 16 weeks, 24 weeks and 36 weeks and postnatal by ultrasound scan.The main follow-up methods were medical record tracking and telephone follow-up, the main contents of follow-up included fetal development and health status after birth.Result： 299 cases of NT^3.0 ram, 67 cases （ 22.4% ） underwent prenatal diagnosis showed chromosome disease.When chromosomal abnormalities were excluded, 12.1% （ 21/174 ） fetuses were found to have structural abnormalities of the fetus 16 weeks before the gestation period.24 weeks before pregnancy, 20.8% of the fetuses found structural abnormalities.When fetal chromosomal abnormalities and ultrasound structural abnormalities were excluded during pregnancy, the healthy birth rate was 97.8% （90/92） .Conclusion： Fetal NT thickening is associated with chromosomal abnormalities and structural abnormalities of the fetus, NT thickening should not be the only indication of fetal termination of pregnancy.When fetal chromosomal abnormalities and ultrasound structural abnormalities are excluded during pregnancy, a healthy survival rate is higher after birth.

关 键 词：胎儿 颈项透明层厚度 预后 

分 类 号：R714.5[医药卫生—妇产科学]