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Analysing the Correlation between Abnormal Markers of First-trimeser Down’s Syndrome Screening and Adverse Perinatal Outcome

Author: JiangMeiLi
Tutor: LiaoCan
School: Guangzhou Medical College
Course: Obstetrics and Gynaecology
Keywords: Nuchal Translucency Down syndrome screening prenatal diagnosis outcome
CLC: R714.7
Type: Master's thesis
Year: 2011
Downloads: 74
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Abstract


Objective1. This is a retrospective study, the purpose of this study is to access the outcome of the pregnancy with increased Nuchal Translucency (NT) at first trimester between 2008 and 2009. Analysing the correlation between increased NT and adverse pregnancy outcome.2. To access the outcome of the perinatal with an increased risk of first-trimeser Down’s syndrome. Analysing the correlation between increased risk of first-trimeser Down’s syndrome and adverse perinatal outcome.Methods1. The outcome of the pregnancy with increased Nuchal Translucency:a) From 2008 to 2009, 6169 pregnancies who accepted fetal NT measurement were followed up after delivery.b) We classified all cases into four groups according to different thickness of NT and analyzed the relationship between NT thickness and pregnant outcome.2. The perinatal outcome of the pregnancy in increased risk of Down’s combined screening first trimester: a) From 2008 to 2009, 5218 pregnancies who accepted Down’s combined screening first trimester were followed up after delivery.b) We classified all cases into two groups according to using a cut-off level of 1 in 250 and analyzed the relationship between a positive screen and perinatal outcome.3. Follow-up information was obtained by a review of medical records and calling patients.Results1. The outcome of the pregnancy with increased Nuchal Translucency:a) Of 6169 cases who accepted NT measurement, there were 214 cases (3.5%) detected with increased NT. Of all these cases, 178 (83.2%) were successful followed up.b) In these 178 informed cases, 21 cases were terminated (6 chromosomal abnormalities, 4 fetal hydrops, 3 congenital heart diseases, other structure abnormalties and 1 pregnant choice), 157 cases delivered, 1 infant was found to have congenital heart disease. General fetus malformation rate was 11.8%(21/178),fetal anomaly detection rate was 95.2%(20/21)。c) We divided all cases into 4 groups due to the thickness of NT, and analyzed the relationship between the NT thickness and pregnant outcome. It showed us a poor outcome when NT is thicker than 4 mm (35.3% vs 93.2%).2. The perinatal outcome of the pregnancy in increased risk of Down’s combined screening first trimester:a) Of 5218 cases who accepted first-trimeser Down’s syndrome screening, there were 151 cases (2.9%) had a positive screen. Among them, 127(84.1%) were successful followed up.b) These 127 informed cases and the adverse outcomes were identifies and compared with the 3700 cases who screened negative for Down’s syndrome. Who had a positive screen was in significant high-risk of adverse pregnancy outcome(anatomy malformation, 7.1% vs 0.8%, OR 8.7; natural abortion, 1.6% vs 0.1%, OR 19.7). With a positive screen, the incidence of obstetric complications(premature delivery, IGT and polyhydramnio)was significantly higher.Conclusions1. Increased NT has close relationship with poor pregnant outcome. When NT thickness is higher than 4 mm, the pregnancy outcome is very poor.2. Most of the fetus malformation can through the karyotype analysis or ultrasound screening are confirmed, and NT screening is only necessary means screening fetal abnormalities.3. First-trimester Down’s syndrome combined screening can effectively screen chromosome abnormality, specially trisomy 21, with the FGR 2.9%, the DR is 80%. Who had a positive screen, the incidence of anatomy malformation, natural abortion and obstetric complications was significantly higher.

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CLC: > Medicine, health > Obstetrics and Gynaecology > Obstetrics > Perinatal medicine
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