标题：胎儿颈项透明层厚度与宫内感染及胎儿不良结局的相关性

      作者：刘佼佼 1，杨福宝 2    1.安康市妇幼保健院功能科，陕西 安康 725000；2.安康市中心医院超声科，陕西 安康 725000

      卷次： 2021年32卷3期

      【摘要】 目的 探究胎儿颈项透明层(NT)厚度与宫内感染及胎儿不良结局的相关性。方法 选择2017年1月至2019年1月在安康市妇幼保健行孕早期超声检查NT增厚的单胎孕妇127例，根据NT的不同厚度分为2.5~2.9 mm组37例，3.0~3.4 mm组33例，3.5~4.4 mm组24例，≥4.5 mm组23例，颈部水囊瘤组10例，比较各组胎儿的宫内感染、胎儿的染色体异常、结构异常情况以及妊娠不良结局发生率。结果 127例孕妇中胎儿宫内感染8例，感染胎儿NT值为(8.12±2.74) mm，明显高于未感染胎儿的(4.53±1.22) mm，差异具有统计学意义(P<0.05)；127例胎儿中染色体异常 34例，18-三体综合征和 21-三体综合征在染色体异常胎儿中比例较高；127例胎儿中结构畸形 31例，严重心脏畸形 8例；2.5~2.9 mm组胎儿的宫内感染率、染色体异常率、结构畸形发生率、严重心脏畸形发生率分别为0、8.10%、5.41%、0，3.0~3.4 mm组分别为 0、9.09%、12.12%、3.03%，3.5~4.4 mm组分别为 4.17%、29.17%、25.00%、4.17%，≥4.5 mm组分别为13.04%、52.17%、43.48%、8.70%，颈部水囊瘤组分别为40.00%、90.00%、90.00%、40.00%；随NT值增大，胎儿的宫内感染、染色体异常、胎儿结构异常发生率越高，差异均有统计学意义(P<0.05)；共120例孕妇完成随访，不良妊娠结局48例，2.5~2.9 mm组、3.0~3.4 mm组、3.5~4.4 mm组、≥4.5 mm组、颈部水囊瘤组的不良妊娠结局发生率分别为14.29%、18.75%，45.45%、76.19%、70.00%，差异有统计学意义(P<0.05)。结论 NT值与宫内感染及胎儿不良结局相关，且随NT值增大，胎儿的宫内感染、染色体异常、结构异常的发生率增高。
      【关键词】 超声；颈项透明层厚度；宫内感染；妊娠结局；孕妇；胎儿
      【中图分类号】 R714.5 【文献标识码】 A 【文章编号】 1003—6350（2021）03—0336—03

Correlation between fetal nuchal translucency thickness and intrauterine infection, fetal adverse outcomes.
LIUJiao-jiao 1, YANG Fu-bao 2. 1. Department of Function, Ankang Maternal and Child Health Hospital, Ankang 725000,Shaanxi, CHINA; 2. Department of Ultrasound, Ankang Central Hospital, Ankang 725000, Shaanxi, CHINA
【Abstract】 Objective To explore the correlation between fetal nuchal translucency (NT) thickness and intra-uterine infection, fetal adverse outcomes. Methods A total of 127 singleton pregnant women with NT thickening whounderwent early pregnancy ultrasound examination in Ankang Maternal and Child Health Hospital from January 2017 toJanuary 2019 were enrolled. According to different NT thickness, they were divided into 2.5-2.9 mm group (37 cases),3.0-3.4 mm group (33 cases), 3.5-4.4 mm group (24 cases), ≥4.5 mm group (23 cases), and cervical hygroma group(10 cases). The incidence rates of fetal intrauterine infection, fetal chromosomal abnormalities, structural abnormalities,and adverse pregnancy outcomes were compared among all the groups. Results Among the 127 pregnant women, therewere 8 cases with fetal intrauterine infection. NT in infection fetuses was (8.12±2.74) mm, which was significantly high-er than (4.53±1.22) mm in non-infection fetuses (P<0.05). Among the 127 fetuses, there were 34 cases with chromosom-al abnormalities. The proportions of fetuses with 18-trisomy syndrome and 21-trisomy syndrome were higher in fetuseswith chromosomal abnormalities. Among the 127 fetuses, there were 31 cases with structural malformations and 8 caseswith severe cardiac malformations. The incidence rates of fetal intrauterine infection, chromosomal abnormalities, structur-al malformation and severe cardiac malformation in 2.5-2.9 mm group, 3.0-3.4 mm group, 3.5-4.4 mm group,≥4.5 mmgroup and cervical hygroma group were (0, 8.10%, 5.41%, 0), (0, 9.09%, 12.12%, 3.03%), (4.17%, 29.17%, 25.00%,4.17%), (13.04%, 52.17%, 43.48%, 8.70%) and (40.00%, 90.00%, 90.00%, 40.00%), respectively. With NT increased,the incidence rates of fetal intrauterine infection, chromosomal abnormalities and fetal structural abnormalities were in-creased, and the differences were statistically significant (all P<0.05). There were 120 pregnant women completing thefollow-up, and there were 48 cases with adverse pregnancy outcomes. The incidence rates of adverse pregnancy out-comes in 2.5-2.9 mm group, 3.0-3.4 mm group, 3.5-4.4 mm group,≥4.5 mm group, and cervical hygroma group were14.29%, 18.75%, 45.45%, 76.19%, and 70.00%, respectively, and the differences were statistically significant (all P<0.05). Conclusion NT is related to intrauterine infection and adverse pregnancy outcomes. With NT increases, the inci-dence rates of fetal intrauterine infection, chromosomal abnormalities, and structural abnormalities are increased.
      【Key words】 Ultrasound; Thickness of nuchal translucency; Intrauterine infection; Pregnancy outcome; Pregnantwoman; Fetus