孕11～13^(+6)周胎儿NT≥6.0 mm孕妇妊娠结局的随访研究  

Pregnancy outcomes of pregnant women with fetal NT≥6. 0 mm at 11-13^(+6) weeks of gestation: a follow-up study

作　　者：赵媛[1] 傅玉[1] 吴菊[1] 牛翠茹 代维斯[1] 林晓娟[1] 韩娟 孙庆梅[1] ZHAO Yuan;FU Yu;WU Ju(Center for Prenatal Diagnosis, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu 730050, Chin)

机构地区：[1]甘肃省妇幼保健院产前诊断中心,甘肃兰州730050

出　　处：《中国妇幼保健》2018年第8期1815-1818,共4页Maternal and Child Health Care of China

基　　金：兰州市科技局科研课题(2013-3-17);甘肃省出生缺陷防控重点实验室培育基地资助项目(1506RTSA158)

摘　　要：目的评价孕早期胎儿颈后透明层(NT)显著增厚(≥6 mm)与妊娠结局的关联性,为临床医生的决策提供依据。方法选取2012年1月-2015年12月在甘肃省妇幼保健院产前诊断中心进行孕早期单胎NT测量的12 352例孕妇,选择其中NT≥6.0 mm的62例进行妊娠结局追踪随访,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12 352例NT测量病例中,NT值≥3.0 mm者522例,其中NT≥6.0 mm者62例。NT≥6.0 mm者中有42例于20周前终止妊娠,27例(43.5%)行产前诊断提示为染色体病。20例继续妊娠病例中,6例(30%)胎儿中孕期彩超复查未见明显结构异常,且增厚的NT完全消失颈后皮肤厚度(NF)<6.0 mm。出生后随访(6～24个月)发现6例新生儿均健康存活,未发现智力问题或精神运动发育迟缓症状。3例(15%)胎儿20周前发现胎死宫内;2例(10%)胎儿于孕中期系统彩超诊断为胎儿颈后淋巴水囊瘤;2例(10%)胎儿中期结构筛查NF>6.0 mm;5例(25%)超声诊断为先天性心脏病;1例(5%)诊断为膈疝,1例(5%)失访。结论胎儿孕早期NT显著增厚与染色体病及胎儿先天性心脏病等结构异常有明显相关性,但不应作为孕妇终止妊娠的唯一指征。当排除了胎儿染色体异常及中孕期结构筛查未见异常时,胎儿预后较好。Objective To evaluate the correlation between marked thickening of fetal nuchal translucency（ NT）（ ≥6 mm） and pregnancy outcomes,provide a basis for clinical decision-making. Methods A total of 12 352 pregnant women receiving NT measurement of single fetus during the first trimester of prengancy in Center for Prenatal Diagnosis,Gansu Provincial Maternity and Child-care Hospital from January 2012 to December 2015 were selected,and 62 pregnant women of them were found with NT≥6. 0 mm,their pregnancy outcomes were followed up,the follow-up content mainly included fetal intrauterine development situation and neonatal health condition. Results Among 12 352 cases,522 cases were found with NT≥3. 0 mm,and 62 cases were found with NT≥6. 0 mm. Among 62 cases with NT≥6. 0 mm,42 cases terminated pregnancy before the 20 th gestational week,27 cases（ 43. 5%） were indicated as chromosomal diseases by prenatal diagnosis. Among 20 cases continuing pregnancy,6 cases（ 30%） were not found with obviously structural abnormalities in reexamination by color ultrasonography during the second trimester of pregnancy,the thickness of nuchal skin-fold（ NF） was less than 6. 0 mm when the thickened NT disappeared completely. Six neonates were healthy and alive during follow-up for 6-24 months,no intelligent problem or psychomotor retardation symptom was found. Three fetuses（ 15%） were found with intrauterine death before the 20 gestational week,two fetuses（ 10%） were diagnosed as nuchal cystic hygroma by systematical color ultrasonography during the second trimester of pregnancy,two fetuses（ 10%） were found with NF6. 0 mm during the second trimester of pregnancy,5 fetuses（ 25%） were diagnosed as congenital heart diseases,one fetus（ 5%） was diagnosed as diaphragmatic hernia,one fetus（ 5%） was lost to follow up. Conclusion Significant thicking of fetal NT during the first trimester of pregnancy is significantly correlated with chromosomal diseases and fetal structural abnormalities,such as co

关 键 词：颈后透明层 产前诊断 随访 

分 类 号：R714.15[医药卫生—妇产科学]