孕早期胎儿颈项透明层厚度的超声测量价值及与不良妊娠结局的关系

Value of ultrasonic measurement of fetal fetal nuchal translucency thickness in early pregnancy and its relationship with adverse pregnancy outcomes

目的探讨孕早期胎儿颈项透明层厚度(NT)的超声测量价值及其与不良妊娠结局的关系。方法选取在超声医学科接受孕早期NT测量且保留完整妊娠随访资料的300例单胎妊娠孕妇作为研究对象,依据NT测量值将其分为对照组(NT<2.50 mm,n=254)和研究组(NT≥2.50 mm,n=46),比较2组胎儿染色体异常、结构畸形、水囊状淋巴管瘤和胚胎停止发育等不良妊娠结局。结果对照组孕期出现胚胎停止发育2例(含染色体异常1例),孕中期超声检查提示水囊状淋巴管瘤1例(合并染色体异常),不良妊娠结局发生率为1.18%(3/254)。研究组孕早期引产3例(含染色体异常1例),胚胎停止发育4例(含染色体异常2例),孕中期引产17例,其中严重结构畸形12例(合并染色体异常6例)、水囊状淋巴瘤5例(合并染色体异常2例),出生后水囊状淋巴瘤1例,不良妊娠结局发生率为54.35%(25/46),染色体异常率23.91%(11/46)。研究组不良妊娠结局发生率高于对照组,差异有统计学意义(P<0.05)。将研究组孕妇按NT中位数分为2组,>4.02 mm组的不良妊娠结局发生率为69.57%,高于2.50~4.02 mm组的39.13%,差异有统计学意义(P<0.05)。结论孕早期NT超声测量值与孕妇妊娠结局关系密切,对孕期产前诊断、产前咨询服务以及指导科学妊娠具有重要价值。

Objective To explore the value of ultrasonic measurement of fetal nuchal translucency(NT)thickness in early pregnancy and its relationship with adverse pregnancy outcomes.Methods A total of 300 singleton pregnant women who received NT measurement in early pregnancy and kept complete pregnancy follow-up data in department of ultrasound were selected as study objects.The pregnant women were divided into control group(NT<2.50 mm,n=254)and study group(NT≥2.50 mm,n=46)according to NT measurement value.Adverse pregnancy outcomes such as fetal chromosomal abnormalities,structural abnormalities,cystic lymphangioma and embryonic arrest were compared between the two groups.Results In the control group,there were 2 cases of embryonic arrest(including 1 case of chromosomal abnormality)during pregnancy,and 1 case of cystic lymphangioma(accompanying with chromosomal abnormality)detected by ultrasonography in the second trimester of pregnancy.The adverse pregnancy outcome rate was 1.18%(3/254).In the study group,there were 3 cases of induced labor in early pregnancy(including 1 case of chromosomal abnormality),4 cases of embryonic arrest(including 2 cases of chromosomal abnormality),17 cases of induced labor in mid pregnancy,including 12 cases of severe structural malformation(6 cases with chromosomal abnormality)and 5 cases of aquacystic lymphoma(2 cases with chromosomal abnormality),and 1 case of postnatal aquacystic lymphoma.The adverse pregnancy outcome rate was 54.35%(25/46),and the chromosomal abnormality rate was 23.91%(11/46).The incidence of adverse pregnancy outcome in the study group was higher than that of the control group(P<0.05).The pregnant women in the study group were further divided into two groups according to NT median value,and the adverse pregnancy outcome rate of NT>4.02 mm group was 69.57%,which was higher than 39.13%of 2.5 to 4.02 mm group(P<0.05).Conclusion NT value measured by ultrasound in the first trimester of pregnancy is closely related to adverse pregnancy outcomes,which has important value in guiding prenatal diagnosis,prenatal counseling and scientific pregnancy.