CAJ | 학술논문

目的探讨妊娠早期颈项透明层(nuchal translucency,NT)增厚胎儿的妊娠结局.方法以相同顶臀径胎儿的NT值的第95百分位数作为NT增厚的标准,对2008年1月至2009年12月在广州市妇女儿童医疗中心产前诊断为妊娠早期单胎胎儿NT增厚的孕妇行回顾性随访.随访内容主要包括产前检查情况及新生儿出生后健康状况,新生儿随访至出生后至少3个月.采用单因素方差分析和多重比较方法分析不同NT值与胎儿围产结局的关系.结果 178例NT增厚病例中,2例自然流产,19例终止妊娠(21-三体6例、重型α地中海贫血5例、超声发现胎儿畸形7例和1例社会原因),157例分娩新生儿中,1例出生后发现先天性心脏病.总体胎儿异常率为11.8％(21/178),胎儿异常检出率为95.2％(20/21).NT在第95百分位数和2.9 mm之间者的胎儿健康存活率为96.1％(122/127);NT为3.0～3.9 mm者的胎儿健康存活比例为82.4％(28/34);NT≥4.0 mm者的胎儿健康存活比例为35.3％ (6/17)(F=29.08,P＜0.001).结论 NT增厚与不良妊娠结局密切相关,随着NT增厚程度的增加,胎儿健康存活率显著降低.当NT≥4.0 mm时,胎儿健康存活率较低.
목적 탐토임신조기경항투명층(nuchal translucency,NT)증후태인적임신결국.방법 이상동정둔경태인적NT치적제95백분위수작위NT증후적표준,대2008년1월지2009년12월재엄주시부녀인동의료중심산전진단위임신조기단태태인NT증후적잉부행회고성수방.수방내용주요포괄산전검사정황급신생인출생후건강상황,신생인수방지출생후지소3개월.채용단인소방차분석화다중비교방법분석불동NT치여태인위산결국적관계.결과 178례NT증후병례중,2례자연유산,19례종지임신(21-삼체6례、중형α지중해빈혈5례、초성발현태인기형7례화1례사회원인),157례분면신생인중,1례출생후발현선천성심장병.총체태인이상솔위11.8％(21/178),태인이상검출솔위95.2％(20/21).NT재제95백분위수화2.9 mm지간자적태인건강존활솔위96.1％(122/127);NT위3.0～3.9 mm자적태인건강존활비례위82.4％(28/34);NT≥4.0 mm자적태인건강존활비례위35.3％ (6/17)(F=29.08,P＜0.001).결론 NT증후여불량임신결국밀절상관,수착NT증후정도적증가,태인건강존활솔현저강저.당NT≥4.0 mm시,태인건강존활솔교저.
Objective To investigate the perinatal outcome of fetus with increased nuchal translucency (NT) at first trimester.Methods The thickness of NT above 95th percentile of the fetuses with same crown-rump length (CRL) was set as the criteria of increased NT.The outcomes of fetuses with increased NT during early pregnancy from Jan.2008 to Dec.2009 in Guangzhou Women and Children's Medical Center were followed up.The information of ultrasound at second trimester,pregnant complications and delivery outcome were collected.All infants were followed up for 3 months after birth and were divided into four groups according to their different thickness of NT.The relationship between NT thickness and perinatal outcome were analyzed with single factor analysis of variance and multiple comparison method.Results Among the 178 cases we followed up,there were 2 spontaneous fetal losses and 19 terminations whose reasons were Down syndrome (n=6),severe a thalassemia (n =5),fetal malformations (n =7) and social factor (n =1).Among the 157newborns delivered,one was found with congenital heart disease.The rate of abnormal infants was 11.8％ (21/178) and the detection rate of abnormal infants was 9 5.2％ (20/21).Healthy living rate of fetus with NT thickness between 95th percentile and 2.9 mm was 96.1％ (122/127); 82.4％ (28/34) for those with NT thickness between 3.0 mm and 3.9 mm; and 35.3％ (6/17) when NT≥ 4.0 mm.Conclusions Increased NT might have close relationship with poor pregnant outcome.The thicker the NT,the lower the healthy living rate of the fetus.The pregnant outcome is very poor if NT≤4.0 mm.