胎儿颈项透明层厚度与宫内感染及胎儿不良结局的相关性

Correlation between fetal nuchal translucency thickness and intrauterine infection,fetal adverse outcomes.

目的探究胎儿颈项透明层(NT)厚度与宫内感染及胎儿不良结局的相关性。方法选择2017年1月至2019年1月在安康市妇幼保健行孕早期超声检查NT增厚的单胎孕妇127例,根据NT的不同厚度分为2.5~2.9 mm组37例,3.0~3.4 mm组33例,3.5~4.4 mm组24例,≥4.5 mm组23例,颈部水囊瘤组10例,比较各组胎儿的宫内感染、胎儿的染色体异常、结构异常情况以及妊娠不良结局发生率。结果127例孕妇中胎儿宫内感染8例,感染胎儿NT值为(8.12±2.74)mm,明显高于未感染胎儿的(4.53±1.22)mm,差异具有统计学意义(P<0.05);127例胎儿中染色体异常34例,18-三体综合征和21-三体综合征在染色体异常胎儿中比例较高;127例胎儿中结构畸形31例,严重心脏畸形8例;2.5~2.9 mm组胎儿的宫内感染率、染色体异常率、结构畸形发生率、严重心脏畸形发生率分别为0、8.10%、5.41%、0,3.0~3.4 mm组分别为0、9.09%、12.12%、3.03%,3.5~4.4 mm组分别为4.17%、29.17%、25.00%、4.17%,≥4.5 mm组分别为13.04%、52.17%、43.48%、8.70%,颈部水囊瘤组分别为40.00%、90.00%、90.00%、40.00%;随NT值增大,胎儿的宫内感染、染色体异常、胎儿结构异常发生率越高,差异均有统计学意义(P<0.05);共120例孕妇完成随访,不良妊娠结局48例,2.5~2.9 mm组、3.0~3.4 mm组、3.5~4.4 mm组、≥4.5 mm组、颈部水囊瘤组的不良妊娠结局发生率分别为14.29%、18.75%,45.45%、76.19%、70.00%,差异有统计学意义(P<0.05)。结论NT值与宫内感染及胎儿不良结局相关,且随NT值增大,胎儿的宫内感染、染色体异常、结构异常的发生率增高。

Objective To explore the correlation between fetal nuchal translucency(NT)thickness and intrauterine infection,fetal adverse outcomes.Methods A total of 127 singleton pregnant women with NT thickening who underwent early pregnancy ultrasound examination in Ankang Maternal and Child Health Hospital from January 2017 to January 2019 were enrolled.According to different NT thickness,they were divided into 2.5-2.9 mm group(37 cases),3.0-3.4 mm group(33 cases),3.5-4.4 mm group(24 cases),≥4.5 mm group(23 cases),and cervical hygroma group(10 cases).The incidence rates of fetal intrauterine infection,fetal chromosomal abnormalities,structural abnormalities,and adverse pregnancy outcomes were compared among all the groups.Results Among the 127 pregnant women,there were 8 cases with fetal intrauterine infection.NT in infection fetuses was(8.12±2.74)mm,which was significantly higher than(4.53±1.22)mm in non-infection fetuses(P<0.05).Among the 127 fetuses,there were 34 cases with chromosomal abnormalities.The proportions of fetuses with 18-trisomy syndrome and 21-trisomy syndrome were higher in fetuses with chromosomal abnormalities.Among the 127 fetuses,there were 31 cases with structural malformations and 8 cases with severe cardiac malformations.The incidence rates of fetal intrauterine infection,chromosomal abnormalities,structural malformation and severe cardiac malformation in 2.5-2.9 mm group,3.0-3.4 mm group,3.5-4.4 mm group,≥4.5 mm group and cervical hygroma group were(0,8.10%,5.41%,0),(0,9.09%,12.12%,3.03%),(4.17%,29.17%,25.00%,4.17%),(13.04%,52.17%,43.48%,8.70%)and(40.00%,90.00%,90.00%,40.00%),respectively.With NT increased,the incidence rates of fetal intrauterine infection,chromosomal abnormalities and fetal structural abnormalities were increased,and the differences were statistically significant(all P<0.05).There were 120 pregnant women completing the follow-up,and there were 48 cases with adverse pregnancy outcomes.The incidence rates of adverse pregnancy outcomes in 2.5-2.9 mm group,3.0-3.4 mm group,3.5-4.4 mm group,≥4.5 mm group,and cervical hygroma group were 14.29%,18.75%,45.45%,76.19%,and 70.00%,respectively,and the differences were statistically significant(all P<0.05).Conclusion NT is related to intrauterine infection and adverse pregnancy outcomes.With NT increases,the incidence rates of fetal intrauterine infection,chromosomal abnormalities,and structural abnormalities are increased.