目的: 早期妊娠超声测量胎儿颈部透明层(nuchal translucency,NT)厚度,探讨NT与胎儿预后的相关性。方法: 选择2017年1月至2019年1月期间行妊娠早期胎儿NT厚度测量的2 779例孕妇作为研究对象,按照胎儿NT厚度测量结果将其分为NT增厚组(194例)和NT正常组(2 585例),分析不同NT增厚幅度与异常胎儿的关系、不同NT增厚幅度与出现不良妊娠结局的关系。结果: NT增厚组发生不良妊娠结局的比率为30.93%,高于NT正常组的2.36%,差异有统计学意义(P＜0.05)。不同NT增厚幅度分组间发生不良妊娠结局的构成比差异有统计学意义(P＜0.05),且发生不良妊娠结局的比率会随NT厚度的增加而上升;在NT增厚的高龄孕妇中,各年龄组间发生胎儿不良妊娠结局构成比比较差异有统计学意义(P＜0.05),且随着孕妇年龄的增长,发生胎儿不良妊娠结局的比率上升。结论: 胎儿颈部透明层增厚会增加发生不良妊娠结局的比率,妊娠早期通过超声筛查胎儿NT厚度可以提高胎儿畸形筛查率,特别是多发结构畸形的检出率;当NT增厚与高龄因素叠加,将会进一步提升预测发生不良妊娠结局的比率,值得临床推广应用。
Objective: To measure the thickness of fetal nuchal translucency (NT) by ultrasound in early pregnancy and explore the correlation between NT and fetal prognosis. Methods: A total of 2 779 pregnant women who underwent NT thickness measurement in early pregnancy from January 2017 to January 2019 were selected as subjects. According to the results of fetal NT thickness measurement, they were divided into NT thickening group (194 cases) and NT normal group (2 585 cases). The relationship between different NT thickening amplitude groups and abnormal fetuses, and the relationship between different NT thickening amplitude groups and adverse pregnancy outcomes were analyzed. Results: The incidence of adverse pregnancy outcomes in the NT thickening group was 30.93%, which was higher than 2.36% in the NT normal group, and the difference was statistically significant (P＜0.05). There was a significant difference in the incidence of adverse pregnancy outcomes between groups with different NT thickness (P＜0.05), and the incidence of adverse pregnancy outcomes increased with the increase of NT thickness. In the elderly pregnant women with NT thickening, the incidence of fetal adverse pregnancy outcomes among different age groups was statistically significant (P＜0.05), and the ratio of fetal adverse pregnancy outcomes increased with the age of pregnant women. Conclusion: The thickening of transparent layer of fetal neck can increase the incidence of adverse pregnancy outcomes. Ultrasound screening of fetal NT thickness in early pregnancy can improve the screening rate of fetal malformations, especially the detection rate of multiple structural malformations. When NT thickening is combined with advanced age, it will further improve the rate of predicting adverse pregnancy outcomes, which is worthy of clinical application.
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