摘要
Objective:To explore the value of increased fetal cardio thoracic ratio(CTR)in predicting adverse fetal pregnancy outcome during 11-13+6 weeks.Methods:The ultrasonographic features,chromosome or gene detection and the pregnancy outcome of 86 fetuses with increased CTR at 11-13+6 weeks’gestation were retrospectively analyzed.Fetuses were divided into non-structural malformation group(46 cases)and structural malformation group(40 cases)according to results of fetal ultrasound examination.The differences of CTR and nuchal translucency thickness(NT)between the two groups were compared by t test.The area under the curve(AUC)was calculated by constructing the receiver operating curve(ROC)to determine the best diagnostic threshold,sensitivity and specificity of CTR and NT in predicting chromosomal abnormalities.Results:All the 86 fetuses had serious problems such as chromosome or gene abnormalities,or structural malformations.The CTR and NT of the structural malformation group were significantly higher than those of the non-structural malformation group,and the difference was statistically significant(P<0.05).Through villous biopsy of 60 fetuses,47 cases(78.3%,47/60)with haemoglobin Bart’s disease,10 cases(16.7%,10/60)with chromosomal abnormalities were detected,and none abnormalities were detected in other 3 cases.According to the ROC curve,the AUC for CTR and NT to predict chromosomal abnormalities are 0.691 and 0.954,respectively,and the diagnostic cut-off values are 0.57 and 3.6 mm,respectively.The sensitivity is 60.0%and 100%,the specificity is about 79.6%and 85.7%,respectively.Follow-up showed that 5 cases of fetal were death intrauterine,and the remaining 81 cases were induced to labor.The specificity of CTR increase in predicting adverse pregnancy outcome was 100%.Conclusion:The increase of CTR in 11-13+6 weeks of gestation indicates that the fetus may have serious problems and poor clinical prognosis.Attention should be paid to the accurate evaluation of CTR in early pregnancy so as to provide reference for the prediction of fetal pregnancy outcome.
基金
Guangdong Provincial Medical Research Fund(No.A2018159)。
