超声探讨胎儿颈项部软组织厚度与先天性心脏疾病的关系

Relationship Between Major Structural Cardiac Defects and Increased Nuchal fold by Ultrasound

目的评估在中孕早期对胎儿颈项部软组织厚度（nuchal fold，NF）的测量对检出胎儿早期先天性心脏病的临床诊断价值。方法2008年1月～2009年1月，在孕14～23周对胎儿颈项部软组织NF厚度进行测量，同时在20-26周对胎儿进行系统详细超声检查及胎儿超声心动图检查，对相关胎儿进行染色体检查。结果超声共对11,421例胎儿检查，对其中1,334例胎儿进行NF测量，共检出NF增厚胎儿69例，检出患心脏主要畸形的胎儿94例，其中533例进行染色体检查，485例染色体正常，这其中查出心脏畸形28例（5．7％）。染色体异常组中有18例接受胎儿心超检查．查出心脏畸形6例（33．3％）。在染色体正常的胎儿中，心脏畸形检出率从4．8％（NF〈6mm）上升到22．2％（NF≥6mm）。结论超声探察胎儿NF对胎儿心脏疾病的检出具有较好的早期提示作用，并可指导临床预测胎儿的预后。

Objective To evaluate the utility of fetal nuchal fold thickness（NF） in the prediction of fetal cardiac malformations in the early second-trimester.Methods Patients referred from January 2008 to January 2009 ,Fetal nuchal fold thickness was performed in early second-trimester fetal sonography at 14-23 gestational weeks, Chromosome analysis, fetal echocardiography and detail fetal sonography were performed at weeks 20-26. Results NFs were measured sonographically in 1,334/11,421 with 69 cases of increased NF. Major fetal cardiac malformations was identified in 94 of 1,334 fetuses, about 533 fetal Chromosome analysis were performed, 485 with normal karyotype,28 （5.7%） of which were heart defects with normal karyotype. 18 fetal with abnormal karyotype accepted fetal echocardiography, 6 （33.3%） of which were heart defects. Fetal cardiac malformations increased from 4.8% （NF〈6mm） to 22.2% （NF ≥ 6 mm）.Conclusions A variety of fetal cardiac malformations are associated with an increased NF in the early second-trimester of pregnancy. It may helpful in predicting the fetal outcome.