超声诊断孕早期胎儿颈部水囊状淋巴管瘤

摘要

Objective To discuss the diagnostic value of ultrasonography in fetus nuchal cystic hygroma CNCH) in early pergnancy. Methods Cystic dilatation of neck was found in 36 fetuses among pregnant women who accepted nuchal trans-lucency examination from Jan 2005 to Aug 2011. Cystic dilatation' position, size, internal echo and whether accompanied by fetal hydrops, abnormal in head, thorax, abdomen, limbs and umbilical core were observed with ultrasound. And the situation of postpartum newborn, chromosome karyotype and results of induced labour were followed up. Results In 36 fetuses, 1 NCH located in axilla and 35 located in the neck. Chromosome examinations were performed in 13 fetuses, and 6 were normal) chromosome karyotype of 3 fetuses were 45, XO; 1 fetus was 46, XX/45, XO; 1 fetus accompanied with Barts hydrops fetalis; 1 fetus was trisomy 21; 1 fetus accompanied upper limb enstrophe, the chromosome karyotype was 46, XY. Among all 36 fetuses. 1 fetus accompanied with hypospadia, 3 accompanied with hydrosarca and dead fetus in uterus in the second trimester, 3 accompanied with cardiac and induction delivery during middle and late pregnancy, while 2 fetuses returned to be normal during pregnancy and were born normally, no obvious structural anomalies were observed in 6 months postpartum. Other 27 fetuses were inducted delivery and confirmed with autopsy. Conclusion Through performing nuchal translucency examination, NCH can be diagnosed in early pregnancy. Judging septated or non-septated hygroma or malformations with ultrasonography helps to evaluating fetus prognosis, management pregnancy, termination of pregnancy at the right moment as well as perform aristogenesis.%目的 探讨孕早期胎儿颈部水囊状淋巴管瘤(NCH)的超声诊断价值.方法 收集2005年1月-2011年8月在我院发现的NCH胎儿36胎,超声观察其囊状扩张的部位、大小、内部情况及胎儿有无水肿,头部、胸腹内脏、四肢、脐带有无异常,并进行随访,记录产后新生儿复查情况或染色体、引产的结果.结果 36胎NCH胎儿中,1胎NCH位于腋下,35胎位于颈部.13胎接受染色体检查,其中6胎染色体核型正常;7胎异常染色体核型中,3胎核型为45,XO；1胎为46,XX/45,XO；1胎Bart's水肿；1胎21-三体;1胎合并上肢内翻,46,XY.全部36胎中,1胎出生后证实合并尿道下裂；3胎合并全身水肿,中、晚孕胎死宫内；3胎合并心脏畸形,在中、晚孕期接受引产;2胎单房性淋巴水囊瘤自行消失,出生后观察至产后6个月,未见明显结构异常；其余27胎均引产,并经尸体检查证实.结论 孕早期超声可在检测胎儿颈部透明层厚度的同时早期诊断NCH,判断有无分隔、合并畸形,对临床医师评估胎儿预后、指导临床处置、适时终止妊娠、实行优生优育有重要临床意义.