摘要
目的探讨早孕期颈项透明层(NT)增厚预测胎儿染色体异常及妊娠结局的临床应用价值。方法对2017年1月—2020年4月早孕期(孕11~13+6周)胎儿NT≥2.5 mm且进行产前诊断的204例单胎妊娠病例进行回顾性分析,按NT厚度依次分为4组:2.5 mm≤NT<3.0 mm(46例)、3.0 mm≤NT<4.0 mm(92例)、4.0 mm≤NT<5.0 mm(42例)和5.0 mm≤NT(24例),并根据超声筛查结果分为单纯NT增厚组(166例)和NT增厚合并超声筛查异常组(38例),统计胎儿染色体异常结果,随访胎儿妊娠结局。结果204例孕妇中检出胎儿染色体异常49例,检出率为24.02%。2.5 mm≤NT<3.0 mm、3.0 mm≤NT<4.0 mm、4.0 mm≤NT<5.0 mm和5.0 mm≤NT组胎儿染色体异常检出率依次为6.52%、21.74%、35.71%和45.83%,随NT厚度增加而升高,4组比较差异有统计学意义(χ^(2)=17.384,P<0.001)。单纯NT增厚组、NT增厚合并超声筛查异常组胎儿染色体异常检出率分别为15.06%和63.16%,两组比较差异有统计学意义(χ^(2)=39.196,P<0.001)。204例胎儿中,自然流产1例,死胎3例,引产41例,正常分娩159例。随着NT厚度增加,胎儿不良结局(流产/死胎/引产)的发生率也升高,比较差异有统计学意义(χ^(2)=14.455,P<0.001)。NT增厚合并超声异常组的不良结局明显高于单纯NT增厚组,两组比较差异有统计学意义(χ^(2)=34.881,P<0.001)。结论NT增厚是一个有效的早孕期产前筛查指标,NT厚度增加、合并超声异常时提示胎儿染色体异常的风险升高,与不良妊娠结局密切相关。
Objective To explore the clinical value of increased nuchal translucency(NT)in early pregnancy in predicting fetal chromosomal abnormality and pregnancy outcome.Methods A retrospective analysis was conducted on 204 single pregnancy cases with NT≥2.5 mm in early pregnancy(11-13+6 weeks)and prenatal diagnosis from January 2017 to April 2020.They were divided into four groups according to NT thickness:2.5 mm≤NT<3.0 mm(46 cases),3.0 mm≤NT<4.0 mm(92 cases),4.0 mm≤NT<5.0 mm(42 cases),5.0 mm≥NT(24 cases),according to the results of ultrasound screening,they were divided into two groups:NT thickening group alone(166 cases)and NT thickening group combined with ultrasound screening abnormality(38 cases).The results of fetal chromosomal abnormality were counted and the fetal pregnancy outcome was followed up.Results Fetal chromosome abnormality was detected in 49 of 204 pregnant women(24.02%).The detection rates of chromosomal abnormalities in 2.5 mm≤NT<3.0 mm,3.0 mm≤NT<4.0 mm,4.0 mm≤NT<5.0 mm and 5.0 mm≤NT groups were 6.52%,21.74%,35.71%and 45.83%,respectively,and increased with the increase of NT thickness,there was statistically significant difference among the four groups(χ^(2)=17.384,P<0.001).The detection rates of chromosomal abnormalities were 15.06%and 63.16%in the NT thickening alone group and the NT thickening combined with ultrasound screening group,respectively,and the difference was statistically significant(χ^(2)=39.196,P<0.001).Among the 204 fetuses,1 had spontaneous abortion,3 had stillbirth,41 had induced labor and 159 had normal delivery.With the increase of NT thickness,the incidence of fetal adverse outcome(abortion/stillbirth/induced labor)also increased,and the difference was statistically significant(χ^(2)=14.455,P<0.001).The adverse outcome of NT thickening combined with ultrasonic abnormality was significantly higher than that of NT alone,and the difference between the two groups was statistically significant(χ^(2)=34.881,P<0.001).Conclusion Increased NT is an effective index f
作者
何凌
卢庆
黄爱萍
王朝红
韦庆芳
黄建春
HE Ling;LU Qing;HUANG Aiping;WANG Zhaohong;WEI Qingfang;HUANG Jianchun(Department of Obstetrics,Nanning Second People’s Hospital,Nanning,Guangxi Zhuang Autonomous Region,530021 China)
出处
《中外医疗》
2021年第25期181-185,共5页
China & Foreign Medical Treatment
关键词
颈项透明层增厚
染色体异常
妊娠结局
Increased nuchal translucency
Chromosomal abnormalities
Pregnancy outcome