孕早期胎儿颈项透明层增厚与胎儿预后的关系

Relationship between the thickening of fetal nuchal translucency in first trimester and fetal prognosis

目的:探讨孕早期胎儿颈项透明层(nuchal translucency,NT)增厚与胎儿预后的关系。方法:选取2019年2月至2020年2月在武汉大学中南医院行超声检查且显示NT增厚的100例孕妇为研究对象。将NT增厚的孕妇分为3组:3.0 mm~组、4.0 mm~组、5.0 mm~组。记录孕妇产前诊断结果及妊娠结局,并比较NT 3.0 mm~组、4.0 mm~组、5.0 mm~组胎儿染色体异常、结构异常、妊娠终止、健康存活发生率及染色体异常类型检出率,分析NT值与胎儿染色体异常、结构异常的相关性。结果:100例NT增厚的孕妇中,染色体异常检出率为31.00%(31/100),结构异常检出率为16.00%(16/100),妊娠终止率为50.00%(50/100),健康存活率为47.00%(47/100)。不同NT组胎儿染色体异常、结构异常发生率、妊娠终止率及健康存活率比较,差异均有统计学意义(均P<0.05)。NT 5.0 mm~组胎儿Turner综合征检出率显著高于3.0 mm~组和4.0 mm~组(均P<0.05)。不同组胎儿13-三体综合征、18-三体综合征、21-三体综合征检出率比较,差异均无统计学意义(均P>0.05)。孕早期胎儿NT厚度与染色体异常、结构异常存在呈明显正相关(均P<0.05)。结论:孕早期胎儿NT增厚与胎儿染色体异常、结构异常呈明显正相关,可作为评估胎儿不良妊娠结局的一项重要指标。

Objective:To investigate the correlation between fetal nuchal translucency(NT)thickening in the first trimester and fetal prognosis.Methods:A total of 100 cases of pregnant women with NT thickening who underwent ultrasound examination in Zhongnan Hospital of Wuhan University from February 2019 to February 2020 were selected as research objects.The pregnant women with NT thickening were divided into 3 groups:a 3.0 mm-group,a 4.0 mm-group,and a 5.0 mm-group.The prenatal diagnosis results and pregnancy outcomes of pregnant women were recorded.The incidence of chromosomal abnormalities,structural abnormalities,termination of pregnancy,healthy survival,and detection rate of chromosomal abnormalities in NT 3.0 mm-group,4.0 mm-group,and 5.0 mm-group were compared,and the correlation of NT value with fetal chromosomal abnormalities and structural abnormalities was analyzed.Results:Among 100 pregnant women with NT thickening,the detection rate of chromosomal abnormalities was 31.00%(31/100),the detection rate of structural abnormalities was 16.00%(16/100),the termination rate of pregnancy was 50.00%(50/100),and the healthy survival rate was 47.00%(47/100).There were statistically significant differences in the incidence of fetal chromosomal abnormalities,structural abnormalities,pregnancy termination rate,and healthy survival rate among different NT groups(all P<0.05).The detection rate of fetal Turner syndrome in the NT 5.0 mm-group was significantly higher than that in the 3.0 mm-group and the 4.0 mm-group(both P<0.05).There was no significant difference in the detection rates of fetal trisomy 13,trisomy 18,and trisomy 21 among different groups(all P>0.05).There was a significant positive correlation of fetal NT value in first trimester with chromosomal abnormalities and structural abnormalities(both P<0.05).Conclusion:NT thickening in first trimester is positively correlated with fetal chromosomal abnormalities and structural abnormalities,which can be used as an important indicator to evaluate fetal adverse pregnancy outcomes.