Türkiye’nin Trakya Bölgesi’nde Fetal Nazal Kemik Uzunluk, Prenazal Kalınlık ve Korpus Kallozum Ölçümü
Öz
Amaç: Nazal kemik fetüste onuncu haftadan itibaren ultrason ile tespit edilebilir. Nazal kemik aplazisi ya da hipoplazisi durumunda kromozomal anomali riski artar. Prenazal kalınlık artışı da Down sendromlu fetüslerde ikinci trimester sırasında sıklıkla gözlenir. Bunlara ek olarak, korpus kallozum da on sekizinci haftadan itibaren fetüslerde ultrason ile tespit edilebilir. Bu yapının agenezisi ya da disgenezisi nöral bozuklulara sebep olur. Bu çalışmada on dokuz ile yirmi üçüncü hafta arasındaki fetüslerde nazal kemik uzunluğu, prenazal kalınlık ve korpus kallozum uzunluğu için nomogram hazırlamayı amaçladık.
Materyal ve Metot: 1 Aralık 2018 ile 31 Aralık 2019 tarihleri arasında Trakya Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği Perinatoloji Polikliniğinde tarafımızca takip edilen gebelerin dosyaları incelendi. Çalışmaya 19 ile 23 gebelik hafta arasındaki 167 hasta alındı.
Bulgular: Nazal kemik uzunluğu, prenazal kalınlık ve korpus kallozum uzunluğu gebelik haftası ilerledikçe artmış gözlendi. Nazal kemik uzunluğu, prenazal kalınlık ve korpus kallozum (mm) uzunluğu için Mean±SD sırasıyla 6.65±0.7, 4±0.5, 20.1±1.4 bulundu.
Sonuç: İkinci trimester ultrason muayenesi sırasında nazal kemik uzunluğu, prenazal kalınlık ve korpus kallozum uzunluğu ölçülebilir. Bu ölçümler kromozomal anomaliler ve genetik hastalıkların prenatal tanısında önemlidir.
Anahtar Kelimeler
Kaynakça
- 1. Rembouskos G, Cicero S, Longo D, Vandecruys, H, Nicolaides KH. Assessment of the fetal nasal bone at 11-14 weeks of gestation by three-dimensional ultrasound. Ultrasound Obstet. Gynecol. (2004). doi:10.1002/uog.952 2. Alldred SK, Takwoingi Y, Guo B, Pennant M, Deeks JJ, Neilson JP, et al. First trimester ultrasound tests alone or in combination with first trimester serum tests for Down’s syndrome screening. Cochrane Database of Systematic Reviews (2017). doi:10.1002/14651858.CD012600 3. Agathokleous M, Chaveeva P, Poon LC, Kosinski P, Nicolaides KH. Meta-analysis of second-trimester markers for trisomy 21. Ultrasound in Obstetrics and Gynecology (2013). doi:10.1002/uog.12364 4. Persico N, Borenstein M, Molina F, Azumendi G, Nicolaides KH. Prenasal thickness in trisomy-21 fetuses at 16-24 weeks of gestation. Ultrasound Obstet. Gynecol. (2008). doi:10.1002/uog.5404 5. Liberati M, Melchiorre K, D’Emilio I, Guanciali-Franchi PE, Celentano C. Fetal facial profile in Pallister-Killian syndrome. Fetal Diagn. Ther. (2007). doi:10.1159/000109220 6. Craven I, Bradburn MJ, Griffiths PD. Antenatal diagnosis of agenesis of the corpus callosum. Clin. Radiol. (2015). doi:10.1016/j.crad.2014.11.004 7. Malinger G, Zakut H. The corpus callosum: Normal fetal development as shown by transvaginal sonography. Am. J. Roentgenol. (1993). doi:10.2214/ajr.161.5.8273605 8. Paladini D, Pastore G, Cavallaro A, Massaro M, Nappi C. Agenesis of the fetal corpus callosum: sonographic signs change with advancing gestational age. Ultrasound Obstet. Gynecol. (2013). doi:10.1002/uog.12506 9. Narayani BH, Radhakrishnan P. Mid-second trimester measurement of nasal bone length in the Indian population. J. Obstet. Gynecol. India (2013). doi:10.1007/s13224-012-0335-5 10. Kanagawa T, Fukuda H, Kinugasa Y, Son M, Shimoya K, Murata Y, Yokoyama T, et al. Mid-second trimester measurement of fetal nasal bone length in the Japanese population. J. Obstet. Gynaecol. Res. (2006). doi:10.1111/j.1447-0756.2006.00429.x 11. Yang PY, Wu JL, Yeh GP, Tsung-Che Hsieh C. Three-dimensional ultrasonography measurement of fetal nasal bone length during the midtrimester in Taiwanese women. Taiwan. J. Obstet. Gynecol. (2012). doi:10.1016/j.tjog.2012.07.006 12. Altunkeser A, Körez MK. Reference ranges for foetal nasal bone length, prenasal thickness, and interocular distance at 18 to 24weeks’ gestation in low-risk pregnancies. BMC Pregnancy Childbirth (2017). doi:10.1186/s12884-017-1602-3 13. Goynumer G, Arisoy R, Yayla M, Erdogdu E, Ergin N. Fetal nasal bone length during the second trimester of pregnancy in a Turkish population. Eur. J. Obstet. Gynecol. Reprod. Biol. (2014). doi:10.1016/j.ejogrb.2014.02.005 14. Bromley B, Lieberman E, Shipp TD, Bnacerraf BR. Fetal nose bone length: A marker for Down syndrome in the second trimester. J. Ultrasound Med. (2002). doi:10.7863/jum.2002.21.12.1387 15. Cusick W, Provenzano J, Sullivan CA, Gallousis FM, Rodis JF. Fetal nasal bone length in euploid and aneuploid fetuses between 11 and 20 weeks’ gestation: A prospective study. J. Ultrasound Med. (2004). doi:10.7863/jum.2004.23.10.1327 16. Maymon R, Levinsohn-Tavor O, Cuckle H, Tovbin Y, Dreazen E, Wiener Y, et al. Second trimester ultrasound prenasal thickness combined with nasal bone length: A new method of Down syndrome screening. Prenat. Diagn. (2005). doi:10.1002/pd.1207 17. De Jong-Pleij EA, Vos FI, Ribber LS, Pistorius LR, Tromp E, Bilardo CM. Prenasal thickness-to-nasal bone length ratio: A strong and simple second- and third-trimester marker for trisomy 21. Ultrasound Obstet. Gynecol. (2012). doi:10.1002/uog.9047 18. Szabó A, Szili K, Szabó JT, Sikovanyecz J, Isaszegi D, Horváth E, et al. Nasal bone length: Prenasal thickness ratio: A strong 2D ultrasound marker for down syndrome. Prenat. Diagn. (2014). doi:10.1002/pd.4442 19. Luders E, Thompson PM, Toga AW. The development of the corpus callosum in the healthy human brain. J. Neurosci. (2010). doi:10.1523/JNEUROSCI.5122-09.2010 20. Jeret JS, Serur D, Wisniewski K, Fisch C. Frequency of agenesis of the corpus callosum in the developmentally disabled population as determined by computerized tomography. Pediatr. Neurosurg. (1985). doi:10.1159/000120229 21. Moutard ML, Kieffer V, Feingold J, Kieffer F, Lewin F, Adamsbaum C, et al. Agenesis of corpus callosum: Prenatal diagnosis and prognosis. Child’s Nerv. Syst. (2003). doi:10.1007/s00381-003-0781-6 22. Govil-Dalela T, Kumar A, Agarwal R, Chugani HT. Agenesis of the Corpus Callosum and Aicardi Syndrome: A Neuroimaging and Clinical Comparison. Pediatr. Neurol. (2017). doi:10.1016/j.pediatrneurol.2016.12.002 23. Romaniello R, Marelli S, Giorda R, Bedeschi MF, Bonaglia MC, Arrigoni F, et al. Clinical Characterization, Genetics, and Long-Term Follow-up of a Large Cohort of Patients with Agenesis of the Corpus Callosum. J. Child Neurol. (2017). doi:10.1177/0883073816664668 24. Santo S, D’Antonio F, Homfray T, Rich P, Pilu G, Bhide A, et al. Counseling in fetal medicine: Agenesis of the corpus callosum. Ultrasound in Obstetrics and Gynecology (2012). doi:10.1002/uog.12315 25. Achiron R, Achiron A. Development of the human fetal corpus callosum: A high-resolution, cross-sectional sonographic study. Ultrasound Obstet. Gynecol. (2001). doi:10.1046/j.0960-7692.2001.00512.x 26. Zhang HC, Yang J, Chen ZP, Ma XY. Sonographic study of the development of fetal corpus callosum in a Chinese population. J. Clin. Ultrasound (2009). doi:10.1002/jcu.20531
Measurement of Fetal Nasal Bone Length, Prenasal Thickness and Corpus Callosum Length of Fetuses in Thrace Region of Turkey
Öz
Objective: The nasal bone can be imaged with ultrasonography (USG) from the 10th week of pregnancy. In situations where the nasal bone is aplastic or hypoplastic, the risk of chromosomal anomalies increases. Thickening of the prenasal soft tissue is also apparent in the vast majority of second-trimester fetuses with Down syndrome. In addition to these, corpus callosum is another fetal structure that can be visualized from 18th weeks of the gestation by ultrasound. Agenesis or dysgenesis of it is related with neuro-disabilities. In this study our objective was to provide reference charts for fetal nasal bone, prenasal thickness and corpus callosum length obtained by prenatal sonography between 19th and 23rd weeks of pregnancy.
Material and Method: The medical records of pregnant women who were followed-up in Trakya University School of Medicine, Department of Obstetrics&Gynecology, Division of Perinatology during the time period of 1st of January 2018 to 31st of December 2019 were reviewed retrospectively. We studied 167 patients in between 19 and 23 weeks of pregnancy.
Results: Nasal bone length, prenasal thickness and corpus callosum length increased as the gestation proceeded. Mean±SD nasal bone length, prenasal thickness and corpus callosum length (mm) between 19th and 23rd weeks were 6.65±0.7, 4±0.5, 20.1±1.4 respectively.
Conclusion: Ultrasound measurements of nasal bone length, prenasal thickness and corpus callosum can be performed within the second-trimester anomaly scan, and these measurements appear to be highly necessary because these measurement sensitive for prenatal diagnosis of chromosomal abnormalities and genetic syndromes.
Anahtar Kelimeler
Kaynakça
- 1. Rembouskos G, Cicero S, Longo D, Vandecruys, H, Nicolaides KH. Assessment of the fetal nasal bone at 11-14 weeks of gestation by three-dimensional ultrasound. Ultrasound Obstet. Gynecol. (2004). doi:10.1002/uog.952 2. Alldred SK, Takwoingi Y, Guo B, Pennant M, Deeks JJ, Neilson JP, et al. First trimester ultrasound tests alone or in combination with first trimester serum tests for Down’s syndrome screening. Cochrane Database of Systematic Reviews (2017). doi:10.1002/14651858.CD012600 3. Agathokleous M, Chaveeva P, Poon LC, Kosinski P, Nicolaides KH. Meta-analysis of second-trimester markers for trisomy 21. Ultrasound in Obstetrics and Gynecology (2013). doi:10.1002/uog.12364 4. Persico N, Borenstein M, Molina F, Azumendi G, Nicolaides KH. Prenasal thickness in trisomy-21 fetuses at 16-24 weeks of gestation. Ultrasound Obstet. Gynecol. (2008). doi:10.1002/uog.5404 5. Liberati M, Melchiorre K, D’Emilio I, Guanciali-Franchi PE, Celentano C. Fetal facial profile in Pallister-Killian syndrome. Fetal Diagn. Ther. (2007). doi:10.1159/000109220 6. Craven I, Bradburn MJ, Griffiths PD. Antenatal diagnosis of agenesis of the corpus callosum. Clin. Radiol. (2015). doi:10.1016/j.crad.2014.11.004 7. Malinger G, Zakut H. The corpus callosum: Normal fetal development as shown by transvaginal sonography. Am. J. Roentgenol. (1993). doi:10.2214/ajr.161.5.8273605 8. Paladini D, Pastore G, Cavallaro A, Massaro M, Nappi C. Agenesis of the fetal corpus callosum: sonographic signs change with advancing gestational age. Ultrasound Obstet. Gynecol. (2013). doi:10.1002/uog.12506 9. Narayani BH, Radhakrishnan P. Mid-second trimester measurement of nasal bone length in the Indian population. J. Obstet. Gynecol. India (2013). doi:10.1007/s13224-012-0335-5 10. Kanagawa T, Fukuda H, Kinugasa Y, Son M, Shimoya K, Murata Y, Yokoyama T, et al. Mid-second trimester measurement of fetal nasal bone length in the Japanese population. J. Obstet. Gynaecol. Res. (2006). doi:10.1111/j.1447-0756.2006.00429.x 11. Yang PY, Wu JL, Yeh GP, Tsung-Che Hsieh C. Three-dimensional ultrasonography measurement of fetal nasal bone length during the midtrimester in Taiwanese women. Taiwan. J. Obstet. Gynecol. (2012). doi:10.1016/j.tjog.2012.07.006 12. Altunkeser A, Körez MK. Reference ranges for foetal nasal bone length, prenasal thickness, and interocular distance at 18 to 24weeks’ gestation in low-risk pregnancies. BMC Pregnancy Childbirth (2017). doi:10.1186/s12884-017-1602-3 13. Goynumer G, Arisoy R, Yayla M, Erdogdu E, Ergin N. Fetal nasal bone length during the second trimester of pregnancy in a Turkish population. Eur. J. Obstet. Gynecol. Reprod. Biol. (2014). doi:10.1016/j.ejogrb.2014.02.005 14. Bromley B, Lieberman E, Shipp TD, Bnacerraf BR. Fetal nose bone length: A marker for Down syndrome in the second trimester. J. Ultrasound Med. (2002). doi:10.7863/jum.2002.21.12.1387 15. Cusick W, Provenzano J, Sullivan CA, Gallousis FM, Rodis JF. Fetal nasal bone length in euploid and aneuploid fetuses between 11 and 20 weeks’ gestation: A prospective study. J. Ultrasound Med. (2004). doi:10.7863/jum.2004.23.10.1327 16. Maymon R, Levinsohn-Tavor O, Cuckle H, Tovbin Y, Dreazen E, Wiener Y, et al. Second trimester ultrasound prenasal thickness combined with nasal bone length: A new method of Down syndrome screening. Prenat. Diagn. (2005). doi:10.1002/pd.1207 17. De Jong-Pleij EA, Vos FI, Ribber LS, Pistorius LR, Tromp E, Bilardo CM. Prenasal thickness-to-nasal bone length ratio: A strong and simple second- and third-trimester marker for trisomy 21. Ultrasound Obstet. Gynecol. (2012). doi:10.1002/uog.9047 18. Szabó A, Szili K, Szabó JT, Sikovanyecz J, Isaszegi D, Horváth E, et al. Nasal bone length: Prenasal thickness ratio: A strong 2D ultrasound marker for down syndrome. Prenat. Diagn. (2014). doi:10.1002/pd.4442 19. Luders E, Thompson PM, Toga AW. The development of the corpus callosum in the healthy human brain. J. Neurosci. (2010). doi:10.1523/JNEUROSCI.5122-09.2010 20. Jeret JS, Serur D, Wisniewski K, Fisch C. Frequency of agenesis of the corpus callosum in the developmentally disabled population as determined by computerized tomography. Pediatr. Neurosurg. (1985). doi:10.1159/000120229 21. Moutard ML, Kieffer V, Feingold J, Kieffer F, Lewin F, Adamsbaum C, et al. Agenesis of corpus callosum: Prenatal diagnosis and prognosis. Child’s Nerv. Syst. (2003). doi:10.1007/s00381-003-0781-6 22. Govil-Dalela T, Kumar A, Agarwal R, Chugani HT. Agenesis of the Corpus Callosum and Aicardi Syndrome: A Neuroimaging and Clinical Comparison. Pediatr. Neurol. (2017). doi:10.1016/j.pediatrneurol.2016.12.002 23. Romaniello R, Marelli S, Giorda R, Bedeschi MF, Bonaglia MC, Arrigoni F, et al. Clinical Characterization, Genetics, and Long-Term Follow-up of a Large Cohort of Patients with Agenesis of the Corpus Callosum. J. Child Neurol. (2017). doi:10.1177/0883073816664668 24. Santo S, D’Antonio F, Homfray T, Rich P, Pilu G, Bhide A, et al. Counseling in fetal medicine: Agenesis of the corpus callosum. Ultrasound in Obstetrics and Gynecology (2012). doi:10.1002/uog.12315 25. Achiron R, Achiron A. Development of the human fetal corpus callosum: A high-resolution, cross-sectional sonographic study. Ultrasound Obstet. Gynecol. (2001). doi:10.1046/j.0960-7692.2001.00512.x 26. Zhang HC, Yang J, Chen ZP, Ma XY. Sonographic study of the development of fetal corpus callosum in a Chinese population. J. Clin. Ultrasound (2009). doi:10.1002/jcu.20531
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 23 Ağustos 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 8 Sayı: 2 |