胎儿颈项透明层超声监测与胎儿发育异常的相关性分析

Correlation of fetal nuchal translucency sonography and abnormal fetal development

目的：探讨超声检测胎儿颈项透明层厚度（NT）与胎儿发育异常的关系,为临床产前诊断提供参考。方法：收集本院行产前检查的孕妇资料1321例（孕11～13＋6周,顶臀长45～84mm）,超声检查测量NT值并随访至产后1周。比较正常胎儿在不同孕周及产妇年龄的NT值变化,并按照不同NT值分组,计算其诊断胎儿发育异常的灵敏度、特异度、阳性预测值和阴性预测值。结果：1所有病例中共46例胎儿NT值≥3.0mm,其中24例存在发育异常（3例染色体核型异常、21例结构异常）;2发育异常病例26例,胎儿NT值≥3.0mm 24例,2例胎儿NT值〈3.0mm（1例染色体核型异常、1例结构异常）;3比较不同孕周及不同年龄孕妇胎儿NT值发现,11～11＋6、12～12＋6、13～13＋6周组别有差异（P〈0.05）,而不同年龄产妇的胎儿NT值比较无差异（P〉0.05）;4比较不同NT值对胎儿发育异常诊断发现,当NT值≥3.0mm时,灵敏度为92.31%,特异度为98.30%;阳性预测值为52.17%,阴性预测值为99.84%。结论：胎儿NT值异常与胎儿发育异常关系密切,早期妊娠中胎儿NT值随着孕周的增加而增加,但与孕妇年龄无关;当NT值≥3.0mm时其对发育异常的诊断灵敏度、特异度、阳性预测值和阴性预测值较均衡;超声监测胎儿NT值可作为孕早期胎儿发育异常筛查的重要指标。

Objective：To explore the relationship of nuchal translucency thickness and fetal developmental abnormalities to provide references for clinical prenatal diagnosis.Methods：We collected the data of 1321 pregnancy women with a gestational age of 11 to 13＋6 weeks and 45 to 84mm of crown rump length who were measured the nuchal translucency thickness（NT）value by ultrasound and underwent a follow-up to 1weeks postpartum in our hospital.We compared the NT value of different weeks of gestation and different maternal age,calculated the sensitivity,specificity,positive predictive value and negative predictive value of the diagnosis of fetal abnormalities.Results：There were 46 cases whose NT value was not less than 3.0mm,of which 24 cases with dysplasia（3cases of abnormal karyotypes,21 cases of abnormal structure）.Twenty-six cases of dysplasia were found,of which 24 cases with not less than 3.0mm of NT value,and 2cases with less than 3.0mm of NT value（1case of abnormal karyotypes,1cases of abnormal structure）.Compared NT value of different gestational age and different maternal age,we found that there were significant differences among groups of 11 to 11＋6,12 to 12＋6,and 13 to 13＋6 weeks of gestation（P〈0.05）,but there were no significant differences in groups of different maternal ages（P〈0.05）.We also found that when the NT value was greater than or equal to 3.0mm,the sensitivity was 92.31%,the specificity was 98.30%,the positive predictive value was52.17%,and the negative predictive value was 99.84%.Conclusion：Fetal NT value has close relationship with abnormal development of fetus in early pregnancy.Fetal NT value rises with the increase of gestational age,but has nothing to do with the maternal age.When the NT value is not less than 3.0mm,the sensitivity,specificity,positive predictive value and negative predictive value are most balanced.And fetal NT value can be used as an important index for early screening of fetal abnormalities.