孕早期胎儿颈项透明层增厚与胎儿预后的关系

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...     

孕早期超声检测胎儿颈项透明层增厚的临床价值

目的探讨孕早期超声检测胎儿颈项透明层(NT)厚度的临床价值并分析妊娠结局,为产前咨询和临床处理提供一定的依据。方法选取2015年3月至2018年2月在我院产前门诊进行孕早期产检的280例NT测量厚度≥2.5 mm的孕妇为研究对象,观察不同NT厚度胎儿畸形检出情况及妊娠结局;分析NT增厚孕妇年龄与染色体异常、结构畸形检出率的关系;探讨NT增厚与TORCH宫内感染的关系。结果随着NT增厚,胎儿染色体异常、结构异常及四肢畸形检出率呈上升趋势,但差异无统计学意义(P>0.05);随着NT增厚,胎儿不良妊娠结局发生率随之增加(P<0.05)。NT增厚孕妇随着年龄的增长,染色体异常、结构畸形检出率逐渐升高(P<0.05)。伴TORCH宫内感染孕妇NT值显著高于未感染者(P<0.05)。结论孕早期进行胎儿NT厚度检测,能较为准确的反应胎儿畸形情况,可作为基层医院早期胎儿畸形的筛查指标。临床工作中需根据孕妇情况及NT不同厚度给予个性化咨询及指导。     

孕早期颈项透明层厚度测量在胎儿产前诊断中的应用分析

目的探讨孕早期超声测量胎儿颈项透明层(nuchal translucency,NT)厚度在产前诊断胎儿染色体疾病及其他结构畸形中的临床价值。方法对2008年9月—2009年8月期间的227名孕11~13+6周胎儿进行NT厚度标准测量,分析NT增厚胎儿的染色体核型、结构及妊娠结局。结果 NT厚度<2.5 mm的胎儿中,染色体及结构正常211例,染色体或结构异常2例。NT厚度≥2.5 mm的胎儿中,6例染色体异常(13-三体综合征1例、18-三体综合征1例、21-三体综合征3例、45X0 1例);3例结构畸形(胎儿多发性结构异常1例、先天性心脏病2例);1例孕20周前不明原因流产;4例无染色体及其他结构异常。正常胎儿的NT厚度呈正态分布,NT厚度随胎龄增加而增厚,男性与女性的NT厚度差异无统计学意义。正常胎儿与异常胎儿头臀长差异无统计学意义;NT厚度异常胎儿的孕妇年龄大于NT厚度正常的孕妇。超声测量NT厚度值设为2.5 mm时,检测胎儿早期异常的灵敏度与特异度比较平衡,分别为80.0%和97.0%。结论 NT厚度的标准化测量是一个早期对胎儿染色体异常、结构异常,尤其是胎儿先天性心脏病筛查的重要指标,有助于早期诊断染色体疾病及其他结构异常,对评价胎儿预后具有较高的临床价值。     

孕早期超声测量胎儿颈项透明层厚度在产前诊断中的应用价值

目的探讨孕早期应用超声测量胎儿颈项透明层(NT)厚度在产前诊断中的应用价值。方法选取我院接受孕早期胎儿系统性产前超声筛查的单胎胎儿2850例,分别测量其头臀径、NT厚度、鼻骨及静脉导管血流频谱等,对孕早期NT增厚(≥2.5 mm)的孕妇于中晚期复查超声,分析NT厚度与异常妊娠的关系。结果孕早期超声检查发现NT厚度<2.5 mm胎儿染色体异常、结构畸形、水囊状淋巴管瘤及胚胎停止发育等异常妊娠的发生率为0.89%,较NT厚度≥2.5 mm胎儿异常妊娠发生率(77.20%)低,差异有统计学意义(P<0.05);44例NT厚度≥2.5 mm胎儿检出染色体核型异常13例,正常21例;NT厚度的增加与异常妊娠的发生率呈正相关(r=0.734,P<0.05)。结论孕早期胎儿NT增厚与胎儿染色体异常及结构畸形等异常妊娠的发生具有相关性,可作为胎儿产前超声筛查的常规项目。     

孕早期颈项透明层厚度测量在胎儿畸形筛查中的应用价值

目的:分析孕早期彩超联合颈部透明层(NT)检查筛查胎儿畸形的概率及其结构.方法:回顾性选取2017年1月—2020年11月在我院进行定期产前检查的14000名孕早期孕妇为研究对象,均进行孕11～13周+6彩超联合颈项透明层检查,同时追踪孕妇孕中期超声检查结果,并随访至其引产或胎儿娩出后,分析早孕期产妇胎儿畸形概率.结果...     

孕早期超声诊断胎儿颈项透明层增厚与妊娠结局的关系探讨

目的:探讨胎儿颈项透明层(NT)增厚与妊娠不良结局的关系。方法:选取2019年7月—2023年7月于重庆市中医院经超声检查胎儿NT增厚的孕妇170例(NT增厚组),选取同时期胎儿NT正常的孕妇200例作为对照(NT正常组),观察胎儿结构有无异常,染色体有无异常,并随访至孕妇妊娠结束。结果:(1) NT增厚组170例孕妇中,正常分娩胎儿存活118例(69.4%),不良妊娠结局52例(30.6%);NT正常组200例孕妇中,正常分娩胎儿存活195例(97.5%),不良妊娠结局5例(2.5%)。NT增厚组不良妊娠结局显著多于NT正常组(P <0.001);进一步分析NT增厚组不同NT厚度与妊娠结局的关系,显示随着NT厚度的增加,不良妊娠结局的发生率明显升高,NT≥5.5 mm组和NT <5.5 mm各组比较,差异均有统计学意义(P <0.05);NT 4.5～<5.5 mm组与NT <4.5 mm各组比较,差异均有统计学意义(P <0.05)。(2) 52例孕妇不良妊娠结局中胎儿结构异常43例,染色体异常16例(其中8例合并结构异常),单纯NT增厚2例;正...     

超声检查应用在胎儿颈项透明层厚度中对筛查胎儿染色体异常的临床价值分析

目的:探究超声检查应用在胎儿颈项透明层(nuchal translucency,NT)厚度中对胎儿染色体异常筛查的临床价值。方法:选取迁安市中医医院2021年4月—2022年4月收治的200例经超声显示胎儿颈项透明层异常而接受羊水染色体核型分析的孕妇为研究对象,对其超声检查结果与羊水染色体核型检测的结果进行分析。结果:200例受检者中,22.50%的胎儿染色体异常,其中染色体数目异常占86.67%,结构异常占8.89%,嵌合体占4.44%。染色体数目异常中,21-三体综合征的发生率最高,与其他染色体异常类型发生率比较差异有统计学意义(P<0.05);胎儿染色体异常率随着其颈项透明层值的增加而逐渐增高,差异有统计学意义(P<0.05)。结论:采用超声对胎儿进行颈项透明层厚度的检查,可为胎儿染色体异常的筛查提供一定的指导依据,颈项透明层值越高,其染色体核型异常的检出率越高。     

颈项透明层厚度可作为胎儿不良围产结局的预测指标

目的探索不同颈项透明层厚度（NT）与胎儿不良围产结局的关系。方法回顾性分析2017年3月~2019年3月于我院分娩的496例孕妇临床资料,筛选其中胎儿NT值异常的98例孕妇（单纯NT值增厚56例,妊娠不良结局42例）为研究对象,依据妊娠结局分为单纯胎儿NT值增厚组56例与妊娠不良结局组42例,对两组NT值、年龄、血清Freeβ-hCG异常率、NIPT染色体异常率进行对比;依据胎儿NT值异常增厚程度分为Ⅰ组：2.50~3.00 mm的,Ⅱ组：3.01~4.00 mm,Ⅲ组：4.01~5.00 mm,Ⅳ组： > 5.00 mm,对不良妊娠结局以及染色体异常发生率进行对比;利用Logistic回归分析法对胎儿围产结局、染色体异常的相关因素进行检验。结果本次研究共发现56例单纯NT值增厚患者,42例妊娠不良结局患者,妊娠不良结局发生率为42.86%;妊娠不良结局组NT值、年龄均大于单纯NT增厚组,妊娠不良结局组血清人绒毛膜促性腺激素游离β亚基（Freeβ-hCG）异常率、NIPT染色体异常率高于单纯NT增厚组（P < 0.05）。各不同胎儿NT值分组孕周、初产妇、BMI、长期吸烟史、糖尿病、高血压数据对比差异不具有统计学意义（P > 0.05）。Ⅰ、Ⅱ组正常胎儿占比高于Ⅲ、Ⅳ组,染色体异常发生率则较低（P < 0.05）。Logistic回归显示,NT值过度增加、年龄偏大、Freeβ-hCG异常及NIPT染色体异常是影响胎儿妊娠结局的危险因素（P < 0.05,OR > 1）;此外,NT值过度增加、年龄偏大是影响染色体异常的危险因素（P < 0.05,OR > 1）,而Freeβ-hCG异常和染色体异常也有显著的关联影响关系（P < 0.05）。结论胎儿NT值能够作为胎儿围产期妊娠不良结局的预测指标,且胎儿NT值增加会提高胎儿发生妊娠不良结局的风险及胎儿染色体异常的发生率。     

超声检查颈项透明层厚度在胎儿染色体异常中的诊断效果及与预后的相关性研究

目的探讨超声检查颈项透明层厚度对胎儿染色体异常患儿预后的相关性。方法选择2016年3月～2018年2月于我院进行产前超声检查的孕妇896例作为研究对象,所有胎儿均进行超声NT标准化测量,记录胎儿染色体异常情况;采用Pearson相关性分析对胎儿染色体异常预后与颈项透明层厚度进行相关性分析。结果 896例孕妇均完成颈项透明层厚度检查,其中NT2.5mm17例,阳性率为1.90%;NT增厚胎儿测量值为2.5～11.86(6.46±1.21)mm;17例NT异常胎儿经病理、随访最终均确诊异常,Pearson相关性分析结果表明:胎儿染色体异常发生率与NT厚度呈正相关性(P0.05)。结论超声检查颈项透明层厚度用于胎儿染色体异常中能获得较高的诊断准确率,且与预后存在相关性,能为临床诊疗提供依据和参考,值得推广应用。     

基于超声探测颈项透明层厚度对胎儿畸形筛查的判断价值

目的:研究基于超声探测颈项透明层厚度(NT)对胎儿畸形筛查的判断价值.方法:选取2019年1月～2020年1月来我院产检的单胎妊娠产妇64例,超声探测胎儿的NT,观察胎儿的解剖结构,并进行随访,观察其最终的妊娠结局,计算通过NT筛查畸形胎儿的敏感度和特异度.结果:本研究中选取的64例产妇中,8例确诊为畸形胎儿,其中7例...     

高频超声检测早孕期胎儿颈项透明层的临床价值

目的：探讨高频超声在早孕期检测胎儿颈项透明层的应用价值。方法：选取我院妊娠期在10～12周进行超声检查且胎儿距母体皮下距离<70 mm的孕妇,共600名,分为3组,每组200名,第1组：孕龄≥10周且<11周,第2组：孕龄≥11周且<12周,第3组：孕龄≥12周且<13周,分别用高频超声和常规超声测量胎儿颈项透明层厚度,比较两种方法的成功率。结果：高频超声和常规超声测量胎儿颈项透明层成功率分别为：第1组：184例和149例,χ2=12.64,P<0.001;第2组：196例和171例,χ2=6.35,P<0.05;两组差异均有统计学意义,第3组：196例和182例,χ2=1.97,P>0.05。结论：早孕期高频超声测量胎儿颈项透明层比常规超声有显著优越性,可以更早、更精确测量胎儿颈项透明层。     

Impact of nuchal cord on measurement of fetal nuchal translucency thickness.

OBJECTIVE: To define the impact of nuchal cord on the measurement of fetal nuchal translucency thickness (NT). METHODS: Between December 2004 and June 2006, we examined prospectively 53 fetuses that were observed on routine first-trimester ultrasound examination between 11 + 3 and 13 + 6 weeks of gestation to have nuchal cord causing an indentation in the skin in the nuchal region. The fetuses were re-examined after a median interval of 132 min, when the cord was no longer around the neck and indentation of the skin had resolved. Various NT measurements (highest, lowest, mean) with the cord located around the neck (nuchal cord) were compared with NT measurements in the absence of nuchal cord ('true' NT) in the same fetuses. Measurements were considered to be equal when they were within mean +/- 1.96 SD, defined by our own intraobserver repeatability according to the method of Bland and Altman. RESULTS: The mean of the largest and the smallest of six measurements in the presence of nuchal cord fell within the mean +/- 1.96 SD of our own intraobserver repeatability, i.e. gave a correct estimate of the true NT, in 80% of fetuses, while the NT was overestimated in 10% and underestimated in 10% of fetuses. The largest and the smallest of six measurements in the presence of nuchal cord gave an underestimate of the true NT in 2% of fetuses and an overestimate in 4% of fetuses, respectively. CONCLUSION: There is a wide scattering of measurements in fetuses with nuchal cord in comparison to the same fetuses in the absence of nuchal cord. This prevents accurate prediction of the true NT, although the largest and smallest of repeat measurements with nuchal cord can allow calculation of the highest and lowest possible risks, respectively. These facts must be taken into consideration in counseling patients.     

早孕期胎儿颈部透明层厚度及静脉导管波形与先天性心脏畸形的关系

目的：探讨早孕期胎儿颈部透明层厚度（Nuchal translucency, NT）及胎儿静脉导管（Ductus venosus, DV）频谱波型与胎儿心脏畸形之间的关系。方法：对2010年6月—2011年6月就诊于我院的孕妇3 112例,于孕11~13+6周测量NT值及DV频谱,并对胎儿进行追踪观察,筛查出心脏畸形的胎儿。结果：NT值和DV血流频谱单独及联合筛查胎儿心脏异常的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为84.6%、95.2%、13.9%、99.9%,95.1%;88.5%,95.6%,15.6%,99.9%,95.5%;81.8%,97.7%,29.5%,99.1%,97.4%。结论：NT值及DV血流频谱异常可作为孕早期胎儿先天性心脏畸形的筛查指标,两者联合应用能够进一步提高筛查的特异性及准确性。     

Screening for trisomy 21 in monochorionic twins by measurement of fetal nuchal translucency thickness.

OBJECTIVE: To determine whether in screening for trisomy 21 by measurement of fetal nuchal translucency (NT) thickness in monochorionic twin pregnancies it is preferable to use the higher, smaller or average NT. METHODS: We retrospectively examined 769 monochorionic twin pregnancies that had undergone NT screening. The selection criteria were that first, in each pregnancy both fetuses were alive at the 11 to 13 + 6-week scan and second, the fetal karyotype had been determined by prenatal invasive testing or the pregnancy outcome was known. In each pregnancy the risk for trisomy 21 was calculated by a combination of maternal age and fetal NT for crown-rump length (CRL). Three estimates of risk for each pregnancy were made using the higher, smaller and average NT and these were compared for detection and false positive rates. RESULTS: The median maternal age was 33 (range, 16-45) years, the CRL was 62 (range, 45-84) mm and gestational age was 12 (range, 11 to 13 + 6) weeks. Either the fetal karyotype was normal, or phenotypically normal babies were born, in 761 cases. The karyotype was abnormal in eight cases, including six with trisomy 21. The estimated risk using the higher, smaller and average NT was 1 in 300 or more in 6 (100%), 4 (66.7%) and 6 (100%) of the trisomy 21 pregnancies and in 148 (19.4%), 57 (7.5%) and 106 (13.9%) of the normal pregnancies. For a detection rate of 100%, the false positive rates using the higher, smaller and average NT would be 5.1%, 45.9% and 4.2%, respectively. CONCLUSION: In monochorionic twins, effective screening for trisomy 21 is best provided by using the average NT measured in the two fetuses.     

The influence of fetal position on nuchal translucency thickness.

OBJECTIVE: To determine whether nuchal translucency thickness is influenced by the fetal position at ultrasound examination. SUBJECTS: Transabdominal ultrasound examination for pregnancy dating and measurement of nuchal translucency thickness was performed at 10-14 weeks' gestation in all women attending the antenatal clinic of our hospital. During the examination special attention was paid to a change in fetal position from prone to supine or vice versa. METHODS: For each fetus the nuchal translucency measurement was repeated when a positional change from prone to supine or vice versa was recorded. All measurements were recorded on hard copy. An image-scoring method was used and evaluated by three independent reviewers. RESULTS: Eighty-five fetuses were included in this study. The mean nuchal translucency for supine fetuses was 1.91 mm compared with 1.93 mm for prone fetuses. The mean quality-score was 6.54 for supine fetuses and 6.55 for prone fetuses. This difference was not statistically significant. CONCLUSION: Fetal position has no influence on the measurement of nuchal translucency.     

Measurement of fetal nuchal translucency thickness by three-dimensional ultrasound.

OBJECTIVE: To investigate the feasibility and repeatability of nuchal translucency thickness measurement using three-dimensional ultrasound. METHODS: Forty consecutive women with uncomplicated singleton pregnancies attending for Down syndrome screening at 11-14 weeks' gestation were included in this prospective crossover trial. Nuchal translucency thickness was measured using both two-dimensional and three-dimensional ultrasound. In each case two three-dimensional volumes were recorded and then examined by using the technique of planar reformatted sections. The initial plane of the first volume always contained a clear image of the nuchal region ('sagittal volume'), whilst the initial plane of the second volume was selected randomly regardless of fetal position ('random volume'). The repeatability of nuchal translucency measurement was examined by constructing a scatter diagram of the difference between the measurements plotted against the mean of two readings. RESULTS: Nuchal translucency measurements could be repeated in 38/40 (95%) sagittal volumes and 24/40 (60%) random volumes. The mean difference between two-dimensional measurements and those obtained by reslicing of sagittal three-dimensional volumes was -0.097 mm (95% limits of agreement from -0.481 to 0.675) and 0.225 mm (95% limits of agreement from -0.369 to 0.819) when random volumes were examined. CONCLUSIONS: Reslicing of stored three-dimensional volumes can be used to replicate nuchal translucency measurements only when nuchal skin can also be clearly seen on two-dimensional ultrasound.     

超声测量胎儿颈项皮肤厚度的初步研究

目的 通过超声检查寻找合适的胎儿颈项皮肤厚度（NT）临界值。方法 对67例早期妊娠（孕10-14周）病例进行超声检查测量颈项皮肤透明层厚度。结果 4例发现异常。1例NT4.0mm因心血管畸形而终止妊娠;1例VT3.6mm为21-三体;2例难免流产 其NT分别为2.7mm 1.9mm.结论 早期妊娠对作超声检查测量NT,对异常者作超声随访或染色检查，可提高胎儿畸形的早期诊断率。早期妊娠时作超声检查测量 NT已成为筛胎儿畸形的一个新指标。