بررسی پیامدهای جنینی در جنین هایی با Nuchal Translucency بالا در غربالگری سه ماهه اول بارداری

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار، گروه زنان و زایمان، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

2 دانشیار، گروه زنان و زایمان، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

3 دستیار تخصصی، گروه زنان و زایمان، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

10.22038/mjms.2025.83636.4805

چکیده

هدف: هدف از این مطالعه، بررسی پیامدهای جنینی در جنین هایی با Nuchal Translucency بالا در غربالگری روتین سه ماهه اول بوده است.

روش: این مطالعه گذشته نگر در یک کلینیک خصوصی پری ناتال در اصفهان از دی ماه ۱۳۹۲ تا ۱۳۹۴ بر روی کلیه زنان باردار دارای حاملگی تک قلو و NT بیش از 3 میلی متر انجام شد. نتایج کاریوتایپ جنین، پیامدهای پری ناتال، درصد نوزادان زنده با/بدون ناهنجاری، سن حاملگی در بدو تولد، وزن هنگام تولد، نمره آپگار 5 دقیقه ای مورد تجزیه و تحلیل قرار گرفت.

یافته‌ها: از 124 مورد، 85 مورد (68.54%) در مطالعه ما دارای قطر NT بین 3 تا 3.99 میلی متر، 20 مورد (16.12%) دارای NT بین 4 تا 4.99 میلی متر، 15 مورد (12.09%) دارای NT بین 5 تا 5.99 میلی متر و 4 مورد (22/3 درصد) NT بیش از 6 میلی متر داشتند.داده های ما ارتباط معنی داری را بین NT و میزان سقط جنین یا IUFD (P-value = 0.000)، میزان سزارین (P-value = 0.037)، زایمان زودرس (P-value = 0.001)، وزن کم هنگام تولد (P-value = 0.001) و آپگار غیر طبیعی (P-value = 0.001) نشان داد. نتایج آزمون اکو (P-value = 0.713)، نتایج آزمایش ژنتیکی (P-value = 0.123) و میزان ناهنجاری (P-value = 0.231) هیچ رابطه معنی‌داری با قطر NT نشان ندادند.

نتیجه‌گیری: در مطالعه حاضر، بین قطر NT و وقوع زایمان زودرس، وزن کم هنگام تولد، میزان سقط یا IUFD، میزان سزارین، آپگار 5 دقیقه‌ای غیرطبیعی و میزان ناهنجاری های مادرزادی رابطه معنی‌داری یافت شد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Fetal outcome in fetuses with high nuchal translucency in the first trimester screening

نویسندگان [English]

  • Farinaz Farahbod 1
  • Elaheh Zarean 2
  • Zahra Hassanpour Amnieh 3
1 Assistant Professor, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
2 Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
3 Resident, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
چکیده [English]

Purpose: The aim of this study was to survey fetal outcomes in the setting of high nuchal translucency at routine first-trimester screening.
Method: This retrospective study conducted in a Private perinatal clinic in Isfahan from the January 2015 to the January 2023 on all pregnant women who had a singleton pregnancy and NT than 3 mm. Fetal karyotype results, perinatal outcomes, percentage of live babies with/without abnormalities, gestational age at birth, birth weight, 5-minute Apgar score were analyzed.
Results: Out of 124 cases, 85 (68.54%) cases in our study had NT diameter between 3 to 3.99 mm, 20 (16.12%) had NT between 4 to 4.99 mm, 15 (12.09%) cases had NT between 5 to 5.99 mm, and 4 (3.22%) cases had NT more than 6 mm. Our data showed significant association between NT and rates of abortion or IUFD (P-value = 0.000), cesarean rate (P-value = 0.037), preterm labor (P-value = 0.001), low birth weight (P-value = 0.001) and abnormal Apgar (P-value = 0.001). Echo test results (P-value = 0.713), genetic test results (P-value = 0.123), malformation rate (P-value = 0.231) didn’t show any significant relationship with NT diameter.
Conclusion: In our study we found significant relationship between the NT diameter and occurrence of preterm labor, low birth weight, rate of abortion or IUFD, cesarean rate, abnormal 5-minute Apgar and malformation rate.

کلیدواژه‌ها [English]

  • Nuchal translucency
  • ultrasound
  • outcome
  • Apgar

مراجع

  1. Roozbeh, N., M. Azizi, and L. Darvish, Pregnancy outcome of abnormal nuchal translucency: a systematic review. Journal of clinical and diagnostic research: JCDR, 2017. 11(3): p. QC12
  2. Contier, A., J. Sichitiu, and W. Rieder, First trimester ultrasound: beyond nuchal translucency. Revue Medicale Suisse, 2023. 19(846): p. 1916-1921
  3. Boutot, M., et al., Follow-up of increased nuchal translucency: Results of a study of 398 cases. Journal of Gynecology Obstetrics and Human Reproduction, 2022. 51(10): p. 102482
  4. Tahmasebpour, A., et al., Increased nuchal translucency and pregnancy outcome. Iranian Journal of Public Health, 2012. 41(11): p. 92
  5. Shakoor, S., et al., Increased nuchal translucency and adverse pregnancy outcomes. the Journal of Maternal-Fetal & Neonatal Medicine, 2017. 30(14): p. 1760-1763
  6. Hellmuth, S.G., et al., Increased nuchal translucency thickness and risk of neurodevelopmental disorders. Ultrasound in Obstetrics & Gynecology, 2017. 49(5): p. 592-598
  7. Pauta, M., R. Martinez‐Portilla, and A. Borrell, Diagnostic yield of next‐generation sequencing in fetuses with isolated increased nuchal translucency: systematic review and meta‐analysis. Ultrasound in Obstetrics & Gynecology, 2022. 59(1): p. 26-32
  8. Cimpoca, B., et al., Increased nuchal translucency at 11–13 weeks' gestation and outcome in twin pregnancy. Ultrasound in Obstetrics & Gynecology, 2020. 55(3): p. 318-325
  9. Wu, N., et al., Practitioner–Specific Medians for Nuchal Translucency to Improve First-Trimester Screening Performance. Obstetrics & Gynecology, 2012. 119(4): p. 785-794
  10. Armour, C.M., et al., Practice guideline: joint CCMG-SOGC recommendations for the use of chromosomal microarray analysis for prenatal diagnosis and assessment of fetal loss in Canada. Journal of medical genetics, 2018. 55(4): p. 215-221
  11. Hui, L., et al., Reexamining the optimal nuchal translucency cutoff for diagnostic testing in the cell-free DNA and microarray era: results from the Victorian Perinatal Record Linkage study. American Journal of Obstetrics and Gynecology, 2021. 225(5): p. 527. e1-527. e12
  12. Rose, N.C., et al., Screening for fetal chromosomal abnormalities: ACOG practice bulletin, number 226. Obstetrics & Gynecology, 2020. 136(4): p. e48-e69
  13. Zhang, Z., et al., Prenatal diagnostic value of chromosomal microarray in fetuses with nuchal translucency greater than 2.5 mm. BioMed Research International, 2019. 2019
  14. Yin, D., et al., Does isolated nuchal translucency from 2.5 to 2.9 mm increase the risk of fetal chromosome disease? Molecular Genetics and Genomics, 2022. 297(6): p. 1643-1648
  15. Wang, C., et al., Chromosomal microarray analysis versus noninvasive prenatal testing in fetuses with increased nuchal translucency. Journal of Human Genetics, 2022. 67(9): p. 533-539
  16. Mastromoro, G., et al., A pain in the neck: Lessons learnt from genetic testing in fetuses detected with nuchal fluid collections, increased nuchal translucency versus cystic hygroma—Systematic review of the literature, meta-analysis and case series. Diagnostics, 2022. 13(1): p. 48
  17. Bet, B.B., et al., Adverse pregnancy outcome in fetuses with early increased nuchal translucency: prospective cohort study. Ultrasound in Obstetrics & Gynecology, 2024. 64(2): p. 164-172.DOI: https://doi.org/10.1002/uog.27623
  18. Kagan, K.O., et al., Relation between increased fetal nuchal translucency thickness and chromosomal defects. Obstetrics & Gynecology, 2006. 107(1): p. 6-10
  19. Nicolaides, K.H., Nuchal translucency and other first-trimester sonographic markers of chromosomal abnormalities. American journal of obstetrics and gynecology, 2004. 191(1): p. 45-67
  20. Roszkowski, T., et al., Increased nuchal translucency in chromosomally normal fetuses and pregnancy outcomes–a retrospective study. Ginekologia polska, 2013. 84(3)
  21. Äyräs, O., et al., Increased nuchal translucency and pregnancy outcome: a retrospective study of 1063 consecutive singleton pregnancies in a single referral institution. Prenatal diagnosis, 2013. 33(9): p. 856-862
  22. Dane, B., et al., Pregnancy outcome in fetuses with increased nuchal translucency. Journal of Perinatology, 2008. 28(6): p. 400-404
  23. Lithner, C.U., M. Kublickas, and S. Ek, Pregnancy outcome for fetuses with increased nuchal translucency but normal karyotype. Journal of Medical Screening, 2016. 23(1): p. 1-6
  24. Souka, A.P., et al., Outcome of pregnancy in chromosomally normal fetuses with increased nuchal translucency in the first trimester. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2001. 18(1): p. 9-17
  25. Mula, R., et al., Increased nuchal translucency and normal karyotype: perinatal and pediatric outcomes at 2 years of age. Ultrasound in obstetrics & gynecology, 2012. 39(1): p. 34-41
  26. Muru, K., et al., Outcome of children with marked changes in maternal screening tests and normal karyotype. Genetics, 2013. 3(1)
  27. Scholl, J., et al., First-trimester cystic hygroma: relationship of nuchal translucency thickness and outcomes. Obstetrics & Gynecology, 2012. 120(3): p. 551-559
  28. Czuba, B., et al., Ultrasonographic assesement of fetal nuchal translucency (NT) at 11th and 14th week of gestation--Polish multicentre study. Neuroendocrinology Letters, 2007. 28(2): p. 175-181
  29. Tekesin, I., Pregnancy outcome in foetuses with increased nuchal translucency–10-years’ experience in a prenatal medical practice. Journal of Obstetrics and Gynaecology, 2020. 40(4): p. 455-460
مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 68، شماره 1
فروردین-اردیبهشت1404
فروردین و اردیبهشت 1404
صفحه 11-18

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