颈项透明层厚度与TORCH宫内感染胎儿发育的关系研究

Correlation betwee nuchal translucency thickness and development of fetuses with intrauterine TORCH infection

  • 摘要: 目的 探索颈项透明层厚度(NT)与TORCH宫内感染胎儿发育的关系。方法 选取2015年1月-2017年1月于医院接受产检152例单胎孕妇和胎儿为研究对象,按照胎儿NT值将胎儿分为颈部水囊瘤组(n=12),2.5~2.9 mm组(n=43),3.0~3.4 mm组(n=37),3.5~4.4 mm组(n=31),≥4.5 mm组(n=29)。计算妊娠孕妇染色体非整倍体风险值,统计异常胎儿例数及构成比,记录各组孕妇妊娠结果。结果 152例胎儿中40例胎儿染色体异常,占比26.32%。核型45,X、18-三体综合征、21-三体综合征在染色体异常胎儿中的构成比和在所有胎儿中的构成比均较高(P<0.05)。颈部水囊瘤组、3.5~4.4 mm组、≥4.5 mm组结构畸形、心脏结构畸形、染色体异常发生率较高(P<0.05)。妊娠结局共56例引产,其中47例发生染色体异常或严重结构畸形,7例属于重型α地中海贫血,2例属于社会因素;引产中颈部水囊瘤组、3.5~4.4 mm组、≥4.5 mm组发生率较高,死胎中颈部水囊瘤组、≥4.5 mm组发生率较高(P<0.05)。结论 超声NT值与胎儿心脏结构异常、染色体异常等胎儿畸形发展有关,且随着超声NT值增加胎儿心脏结构异常、染色体异常等胎儿畸形发展的发生率相应增加。

     

    Abstract: OBJECTIVE To explore the correlation between nuchal translucency thickness (NT) and development of fetuses with intrauterine TORCH infection. METHODS A total of 152 singleton pregnant women and fetuses who received prenatal examination in the hospital from Jan 2015 to Jan 2017 were recruited as the study objects and divided into the neck hygroma group with 12 cases, the 2.5-2.9 mm group with 43 cases, the 3.0-3.4 mm group with 37 cases, the 3.5-4.4 mm group, and the no less than 4.5 mm group with 29 cases according to the fetal NI value. The chromosome aneuploid risk value of the pregnant women was calculated, the number of cases of abnormal fetuses and constituent ratios were taken for statistics, and the pregnancy outcomes of the pregnant women were recorded. RESULTS Of the 152 fetuses, 40 had chromosomal abnormalities, accounting for 26.32%. The constituent ratios of the fetuses with karyotype 45, X, 18-trisomy and 21-trisomy syndrome were high both among the children with chromosomal abnormalities and among all of the fetuses (P<0.05). The incidence rates of structural malformation, cardiac structural malformation and chromosomal abnormalities were high in the neck hygroma group, the 3.5-4.4 mm group, and the no less than 4.5 mm group (P<0.05). Totally 56 pregnant women had the labor induction, 47 of whom had chromosomal abnormalities or severe structural malformation, 7 cases were severe alpha thalassemia, and 2 cases were social factors. The incidence of labor induction was high in the neck hygroma group, the the 3.5-4.4 mm group, and the no less than 4.5 mm group; the incidence of stillbirth was high in the neck hygroma group and the no less than 4.5 mm group (P<0.05). CONCLUSION The NT value is associated with the abnormal development of fetuses such as the fetal cardiac structure abnormality and chromosome abnormality, and the incidence of abnormal development of fetuses with fetal cardiac structure abnormality and chromosome abnormality is increased with the NT value.

     

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