颈部透明层厚度≥第99百分位胎儿的产前诊断与临床结局分析  

Prenatal diagnosis and postnatal outcome of fetus nuchal translucency value≥99%

作　　者：项金莲 朱晨 任芸芸 吴淑道 Xiang Jinlian;Zhu Chen;Ren Yunyun;Wu Shudao(Department of Ultrasound,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China)

机构地区：[1]复旦大学附属妇产科医院超声科,上海200011

出　　处：《中华超声影像学杂志》2024年第4期329-334,共6页Chinese Journal of Ultrasonography

摘　　要：目的探讨颈部透明层(NT)≥第99百分位胎儿的产前诊断结果,并分析与妊娠结局的关系。方法回顾性分析2019年6月至2021年6月在复旦大学附属妇产科医院建档孕妇共21472例,筛选出NT≥第99百分位且有妊娠结局的共307例,按孕周分为三组:11^(+0)~11^(+6)周(A组),12^(+0)~12^(+6)周(B组),13^(+0)~13^(+6)周(C组)。分析三组胎儿的超声结构异常、染色体异常与妊娠结局之间的关系。按合并结构异常或染色体异常与孤立性NT增厚分两组,分析两组之间的妊娠结局情况。结果①A、B、C三组分别有13例、156例、138例,染色体异常检出率分别为30.0%、10.3%、9.1%(χ^(2)=4.362,P=0.113),超声结构异常检出率分别为23.1%、14.1%、10.1%(χ^(2)=2.351,P=0.309),三组比较差异无统计学意义(P>0.05);妊娠结局正常分别为46.2%、77.6%、85.5%,三组比较差异有统计学意义(χ^(2)=12.404,P=0.002)。②合并染色体异常或结构异常组与孤立性NT增厚组妊娠结局异常分别为77.4%、5.7%,两组比较差异有统计学意义(χ^(2)=157.847,P<0.001)。结论在早孕期不同孕周检查,NT≥第99百分位的胎儿染色体异常和超声结构异常检出率无差别,孤立性NT≥第99百分位的胎儿比合并染色体异常或结构异常的胎儿妊娠结局好,出生后新生儿存活率高。Objective To investigate the possible association between prenatal diagnosis and postnatal outcome in fetus with nuchal translucency(NT)value≥99%.Methods From June 2019 to June 2021,a total of 21472 pregnant women were retrospectively enrolled in the Obstetrics and Gynecology Hospital of Fudan University,including 307 cases with NT value≥99%and pregnancy outcome.They were divided into three groups based on gestational age:11+0-11+6 weeks(group A),12^(+0)-12^(+6) weeks(group B)and 13^(+0)-13^(+6) weeks(group C).In all three groups of fetuses,the possible association was determined between ultrasound structural abnormalities and chromosomal abnormalities and different pregnancy outcomes.Fetuses were divided into two groups based on combined structural abnormalities or chromosomal abnormalities and isolated NT thickening,and the pregnancy outcomes were compared between the two groups.Results①There were 13 cases,156 cases,and 138 cases in groups A,B,and C.The detection rates of chromosomal abnormalities were 30.0%,10.3%,and 9.1%of respectively(χ^(2)=4.362,P=0.113),and the detection rates of ultrasound structural abnormalities were 23.1%,14.1%,and 10.1%respectively(χ^(2)=2.351,P=0.309),without statistically significant difference among the three groups(P>0.05).The good pregnancy outcomes were 46.2%,77.6%,and 85.5%respectively,with statistically significant differences among the three groups(χ^(2)=12.404,P=0.002).②Poor pregnancy outcomes occurred in 77.4%of the groups with combined chromosomal or structural abnormalities and 5.7%of the groups with isolated NT thickening,and the difference between the two groups was statistically significant(χ^(2)=157.847,P<0.001).Conclusions During early pregnancy screening at different gestational weeks,there is no difference in the detection rates of chromosomal abnormalities and ultrasound structural abnormalities in fetuses with NT value≥99%.Fetuses with isolated NT value≥99%have better pregnancy outcomes than fetuses with combined chromosomal or structural abnormal

关 键 词：超声检查 胎儿颈部透明层 早孕期筛查 产前诊断 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]