Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2021, Vol. 17 ›› Issue (01): 81 -85. doi: 10.3877/cma.j.issn.1673-5250.2021.01.012

Special Issue:

Original Article

Prenatal diagnosis value of fetal increased nuchal translucency thickness and absence of nasal bone in first trimester

Shaomin Wu1,1, Chan Li1,1, Li Tang1,1, Haiyun Wei1,1, Xin Yang2,2,()   

  • Received:2020-03-03 Revised:2020-11-10 Published:2021-02-01
  • Corresponding author: Xin Yang
  • Supported by:
    National Natural Science Foundation of China(81873836)
Objective

To investigate prenatal diagnosis value of increased nuchal translucency (NT) thickness and absence of nasal bone of fetal in first trimester.

Methods

From October 2016 to April 2019, a total of 488 cases of singleton pregnancy fetus who were screened by ultrasound to confirm the increased NT thickness and/or absence of nasal bone in first trimester in Dongguan People′s Hospital were selected as research subjects. The clinical date of pregnant women of fetus were analyzed retrospectively.Chi-square test was used to compare the incidence of chromosomal abnormalities under 5 ultrasound conditions, including isolated increased NT thickness, isolated absence of nasal bone, increased NT thickness + absence of nasal bone, increased NT thickness + other structure abnormalities, and increased NT thickness + absence of nasal bone + other structure abnormalities. The procedure followed in this study was consistent with World Medical Association Declaration of Helsinki revised in 2013.

Results

①The incidence of chromosomal abnormalities of fetuses who received prenatal diagnosis and diagnosed with increased NT thickness and absence of nasal bone were 17.6% (46/262) and 14.3% (29/203), respectively. ②The incidence of chromosomal abnormalities of fetus with isolated increased NT thickness, isolated absence of nasal bone, increased NT thickness + absence of nasal bone, increased NT thickness + other structure abnormalities, and increased NT thickness + absence of nasal bone + other structure abnormalities were 8.5% (17/200), 3.9% (3/77), 53.5% (23/43), 43.5% (10/23), 42.9% (6/14), respectively. Among them, there was no significant difference of incidence of chromosomal abnormalities between fetus with isolated increased NT thickness and isolated absence of nasal bone (χ2=1.759, P=0.090). There was no significant difference of incidence of chromosomal abnormalities among fetus with the rest of 3 ultrasound conditions (χ2=0.837, P=0.658). But the incidence of chromosomal abnormalities of fetus with these 3 ultrasound conditions were all higher than that of fetus with isolated increased NT thickness, and the differences were statistically significant(χ2=52.080, 23.716, 16.101; all P<0.001).

Conclusions

Nasal bone screening should be included as a screening index of chromosomal abnormality in first trimester, and fetus with nasal bone abnormality should be followed up in second trimester. It is highly recommended that pregnant women take prenatal diagnosis while ultrasound scan showed fetus with increased NT thickness combined with absence of nasal bone and/or with other structure abnormalities to identify fetus condition of occurrence of chromosomal abnormality.

[1]
Nicolaides KH, Azar G, Byrne D, et al. Fetal nuchal translucency: ultrasound screening for chromosomal defects in first trimester of pregnancy[J]. BMJ, 1992, 304(6831):867-869. DOI: 10.1136/bmj.304.6831.867.
[2]
Tang Y, Luo H, Mu D, et al. Early diagnosis of trisomy 21, trisomy 18 and trisomy 13 using nuchal translucency thickness and ductus venosus blood flow waveform in West China[J]. Mol Med Rep, 2019, 19(2):1349-1355. DOI: 10.3892/mmr.2018.9756.
[3]
Chanprapaph P, Dulyakasem C, Phattanchindakun B. Sensitivity of multiple first trimester sonomarkers in fetal aneuploidy detection[J]. J Perinat Med, 2015, 43(3):359-365. DOI: 10.1515/jpm-2014-0201.
[4]
Dane B, Dane C, Cetin A, et al. Pregnancy outcome in fetuses with increased nuchal translucency[J]. J Perinatol, 2008, 28(6):400-404. DOI: 10.1038/jp.2008.14.
[5]
杜柳,谢红宁,郑菊,等. 颈部透明层增厚胎儿中CMA技术检测拷贝数变异的分析[J]. 中华妇产科杂志,2018, 53(10):671-676. DOI: 10.3760/cma.j.issn.0529-567x.2018.10.004.
[6]
Gu YZ, Nisbet DL, Reidy KL, et al. Hypoplastic nasal bone: a potential marker for facial dysmorphism associated with pathogenic copy number variants on microarray[J]. Prenat Diagn, 2019, 39(2):116-123. DOI: 10.1002/pd.5410.
[7]
Węgrzyn P, Czuba B, Serafin D, et al. Nasal bone in screening for T21 at 11-13+6 weeks of gestation - a multicenter study[J]. Ginekol Pol, 2016, 87(11):751-754. DOI: 10.5603/GP.2016.0082.
[8]
谢红宁,朱云晓,李丽娟,等. 对妊娠中晚期孕妇行超声检测胎儿鼻骨发育状况以筛查唐氏综合征[J]. 中华妇产科杂志,2008, 43(3):171-174. DOI: 10.3321/j.issn:0529-567X.2008.03.004.
[9]
Prefumo F, Sairam S, Bhide A, et al. Maternal ethnic origin and fetal nasal bones at 11-14 weeks of gestation[J]. BJOG, 2004, 111(2):109-112. DOI: 10.1046/j.1471-0528.2003.00025.x-i1.
[10]
Salomon LJ, Alfirevic Z, Bilardo CM, et al. ISUOG practice guidelines: performance of first-trimester fetal ultrasound scan[J]. Ultrasound Obstet Gynecol, 2013, 41(1):102-113. DOI:10.1002/uog.12342.
[11]
Sepulveda W, Wong AE, Dezerega V. First-trimester ultrasonographic screening for trisomy 21 using fetal nuchal translucency and nasal bone[J]. Obstet Gynecol, 2007, 109(5):1040-1045. DOI:10.1097/01.AOG.0000259311.87056.5e.
[12]
杨昕,韩瑾,甄理,等.胎儿鼻骨缺失或发育不良与染色体核型异常的关系—187例分析[J]. 中华围产医学杂志,2015, 18(5):339-342. DOI: 10.3760/cma.issn.1007-9408.2015.05.05.
[13]
Sparks AB, Struble CA, Wang ET, et al. Noninvasive prenatal detection and selective analysis of cell-free DNA obtained from maternal blood: evaluation for trisomy 21 and trisomy 18[J]. Am J Obstet Gynecol, 2012, 206(4):319.e1-e9. DOI:10.1016/j.ajog.2012.01.030.
[14]
Herrera LG, Royero LR, Rodríguez NG, et al. Effectiveness of increased nuchal translucency in detecting pregnancies at risk for chromosomal abnormalities[J]. MediSur, 2014, 12(1):63-76.
[15]
Agathokleous M, Chaveeva P, Poon LC, et al. Meta-analysis of second-trimester markers for trisomy 21[J]. Ultrasound Obstet Gynecol, 2013, 41(3):247-261. DOI: 10.1002/uog.12364.
[16]
Ting YH, Lao TT, Lau TK, et al. Isolated absent or hypoplastic nasal bone in the second trimester fetus: is amniocentesis necessary?[J]. J Matern Fetal Neonatal Med, 2011, 24(4):555-558. DOI: 10.3109/14767058.2010.487140.
[17]
Desai P , Chauhan B , Jhawar M. Outcome of pregnancies with isolated absent fetal nasal bone in the second trimester[J]. J Fetal Med, 2019, 6(4): 31-34.DOI: 10.1007/s40556-019-00196-9.
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