摘要
目的探讨迷走右锁骨下动脉(ARSA)在胎儿染色体异常筛查中的临床意义。方法回顾性分析2017年1月至2018年5月在新乡市中心医院行产前超声检查的孕妇4862例临床资料,共检出ARSA胎儿36例,所有胎儿进行随访,并总结其超声图像与染色体核型结果及临床结局。结果36例ARSA均由三血管气管切面检出,其中25例单纯性ARSA胎儿染色体核型正常,均为足月活产,随访12个月身体发育良好,未出现呼吸道及食管压迫症状;11例复杂性ARSA胎儿合并心内外畸形或超声软指标异常,遗传学检查证实9例为21-三体综合征、1例为18-三体综合征、1例为22q11微缺失综合征,经产前咨询均终止妊娠。结论单纯ARSA预后良好,不会增加患非整倍体的风险。ARSA合并心内外畸形或多发超声软指标异常时,染色体异常风险性高,复杂性ARSA是胎儿染色体异常的有效预测指标。
Objective To investigate the clinical significance of aberrant right subclavian artery(ARSA)in the screening of fetal chromosome abnormalities.Methods From January 2017 to May 2018,4862 pregnant women were examined by ultrasound before delivery in Xinxiang Central Hospital.A total of 36 fetuses with aberrant right subclavian artery were detected.All fetuses were followed up.The ultrasound images,karyotype results and clinical outcome were summarized.Results All 36 cases of ARSA were detected by three vessels and trachca view.of which 25 cases of simple ARSA fetuses had normal karyotype,all of them were alive and term delivery.The body developed well for 12 months,and no symptoms of respiratory tract and esophageal compression occurred.11 cases of complex ARSA fetuses were abnormal in cardiac structure and ultrasonic soft index,9 cases of 21-trisomy,1 case of 18-trisomy and 1 case of 22q11 microdeletion were confirmed by chromosome examination,and 11 cases were terminated pregnancy by antenatal consultation.Conclusion ARSA alone has a good prognosis and does not increase the risk of aneuploidy.If there are cardiac defects,extracardiacanomalies or multiple abnormal ultrasonic soft indexes,the risk of chromosome abnormalities is high.Aberrant right subclavian artery with additional ultrasound findings constitute a strong predictor for fetal chromosome abnormalities.
作者
韩华
李建玲
HAN Hua;LI Jianling(Xinxiang Central Hospital,Xinxiang,Henan 453000,China)
出处
《现代医药卫生》
2020年第13期1984-1986,1990,共4页
Journal of Modern Medicine & Health
关键词
胎儿
迷走右锁骨下动脉
染色体异常
诊断
Fetus
Aberrant right subclavian artery
Chromosome karyotype
Diagnosis
作者简介
韩华(1972-),硕士研究生,副主任医师,主要从事妇产科超声诊断的研究。
