摘要
OBJECTIVE: Assessing the role of fetal ductus venosus and nasal bones evalua ti on in first-trimester screening for Down syndrome. METHODS: This was a prospect ive cohort study in a tertiary referral fetal medicine unit involving 628 consec utive fetuses undergoing chorionic villus sampling. The indication for chorionic villus sampling was an increased risk (more than 1:300) for trisomy 21 based on maternal age and nuchal translucency screening in 313 cases (54.7%), increased maternal age in 195 (34.1%), and other in 64 (11.2%). Immediately before chor ionic villus sampling, an ultrasound examination was performed. The pattern of b lood flow in the ductus venosus and the presence or absence of the nasal bones w as noted. RESULTS: A satisfactory examination of both ductus venosus and nasal b ones was possible in 572 fetuses. Of these, 497 (86.9%) had a normal karyotype, and 47 (8.2%) were affected with Down syndrome. The likelihood ratio for triso my 21 was 7.05 (95%confidence interval 4.27-11.64) in the case of abnormal duc tus venosus flow and 6.42 (95%confidence interval 3.86-10.67) in the case of a bsent nasal bones. CONCLUSION: In addition to increased fetal nuchal translucenc y, Down syndrome is significantly associated with first-trimester abnormal flow velocity patterns in the ductus venosus and hypoplasia of the nasal bones.
OBJECTIVE: Assessing the role of fetal ductus venosus and nasal bones evalua ti on in first-trimester screening for Down syndrome. METHODS: This was a prospect ive cohort study in a tertiary referral fetal medicine unit involving 628 consec utive fetuses undergoing chorionic villus sampling. The indication for chorionic villus sampling was an increased risk (more than 1:300) for trisomy 21 based on maternal age and nuchal translucency screening in 313 cases (54.7%), increased maternal age in 195 (34.1%), and other in 64 (11.2%). Immediately before chor ionic villus sampling, an ultrasound examination was performed. The pattern of b lood flow in the ductus venosus and the presence or absence of the nasal bones w as noted. RESULTS: A satisfactory examination of both ductus venosus and nasal b ones was possible in 572 fetuses. Of these, 497 (86.9%) had a normal karyotype, and 47 (8.2%) were affected with Down syndrome. The likelihood ratio for triso my 21 was 7.05 (95%confidence interval 4.27-11.64) in the case of abnormal duc tus venosus flow and 6.42 (95%confidence interval 3.86-10.67) in the case of a bsent nasal bones. CONCLUSION: In addition to increased fetal nuchal translucenc y, Down syndrome is significantly associated with first-trimester abnormal flow velocity patterns in the ductus venosus and hypoplasia of the nasal bones.
