妊娠早期胎儿颈部透明层厚度与胎儿预后的关系

Relationship between fetal nuchal translucency and fetal prognosis in early pregnancy

目的观察妊娠早期胎儿颈部透明层厚度(NT)与胎儿预后的关系。方法临床选择2019年1月-2019年12月在本院进行产检、建档且至妊娠完成随访的孕早期妊娠女性152例,均为胎儿NT值异常者,根据妊娠结局分组,分为妊娠不良结局组、NT值单纯增厚组,比较两组的无创产前DNA检测(NIPT)异常情况、血清人绒毛膜促性腺激素(Free-βHCG)异常情况;比较两组的孕妇年龄、胎儿颈部透明层厚度指标;评估妊娠结局及预后影响因素。结果妊娠不良结局组的NIPT染色体异常情况、Freeβ-HCG异常情况显著高于NT单纯增厚组,差异有统计学意义(P<0.05);妊娠不良结局组的平均年龄、NT值显著高于NT单纯增厚组,差异有统计学意义(P<0.05);本研究纳入孕妇152例,其中不良妊娠结局60例,其中包括流产15例,引产32例,胎死宫内2例,三体综合征11例。不良妊娠结局的发生与胎儿透明层厚度、孕妇年龄、NIPT染色体异常、Freeβ-HCG异常等因素密切相关,差异有统计学意义(P<0.05)。结论胎儿颈部透明层厚度是评估围产期妊娠结局的敏感性指标,胎儿NT值升高会增高妊娠不良结局的风险,临床需进行彩色多普勒超声定期筛查。

Objective:To observe the relationship between fetal nuchal translucency(NT)and fetal prognosis in early pregnancy.Methods:152 pregnant women with abnormal NT value were selected from January 2019 to December 2019 in our hospital.All of them were abnormal fetal NT value.According to the pregnancy outcome,they were divided into adverse pregnancy outcome group and simple NT value thickening group.The abnormal situation of noninvasive prenatal DNA test(NIPT)and serum human chorionic gonadotropin(Free-βHCG)were compared between the two groups.The pregnancy outcomes and prognostic factors were evaluated.Results:The abnormal condition of NIPT chromosome and Free-βHCG in adverse pregnancy outcome group were significantly higher than those in NT simple thickening group(P<0.05);The average age and NT value in the adverse pregnancy outcome group were significantly higher than those in the NT simple thickening group(P<0.05);This study included 152 pregnant women,including 60 cases of adverse pregnancy outcomes,including 15 cases of abortion,32 cases of induced labor,2 cases of fetal death in utero and 11 cases of trisomy syndrome.The incidence of adverse pregnancy outcomes was closely related to fetal nuchal translucency,maternal age,NIPT chromosomal abnormalities,Free-βHCG abnormalities and other factors,the difference was statistically significant(P<0.05).Conclusion:Fetal cervical translucency thickness is a sensitive index to evaluate the perinatal pregnancy outcome.The increase of fetal NT value will increase the risk of adverse pregnancy outcomes.It is necessary to conduct regular screening by color Doppler ultrasound in clinic.