Índice neutrófilo-linfocito, relación plaquetas-linfocito y distribución de la anchura del eritrocito en pacientes con preeclampsia / Neutrophil-to-lymphocyte ratio, plateletto- lymphocyte ratio, and erythrocyte width distribution. and erythrocyte width distribution in patients with preeclampsia

Resumen OBJETIVO: Comparar el índice neutrófilo-linfocito, la relación plaquetas-linfocito y la distribución de la anchura del eritrocito de mujeres con preeclampsia con o sin criterios de severidad y los de mujeres sin ésta. MATERIALES Y MÉTODOS: Estudio retrospectivo, de casos y controles, efectuado en mujeres con y sin preeclampsia atendidas entre enero y diciembre de 2019. RESULTADOS: Se estudiaron 70 mujeres con preeclampsia y 70 con embarazo sin esta complicación. El índice neutrófilo-linfocito fue significativamente mayor en las mujeres con preeclampsia (4.11 ± 2.76; IC95%: 3.47-4.75) que en las mujeres sin esta complicación (2.99 ± 1.6; IC95%: 2.62-3.36; p = 0.004), similar a la relación plaquetas-linfocitos (117.61 ± 47.53; IC95%:106.48-128.24 vs 97.64 ± 43.67; IC95%: 87.41-107.87; p = 0.006) y para la distribución de la anchura del eritrocito (14.46 ± 1.9; IC95%: 14.02-14.9 vs 13.56 ± 1.38; IC95%: 13-13.72; p = 0.0002). Ninguno de estos parámetros logró discriminar entre las pacientes con preeclampsia con o sin criterios de severidad. CONCLUSIÓN: Un índice neutrófilo-linfocito ≥ 5.1 y una relación plaquetas-linfocito ≥ 113.1 son capaces de discriminar de manera adecuada entre preeclampsia con o sin criterios de severidad.

Abstract OBJECTIVE: To compare the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and erythrocyte width distribution, of women with preeclampsia with or without severity criteria and those of women without. MATERIALS AND METHODS: Retrospective case-control study in 70 women with preeclampsia and 70 with normal pregnancy between January and December 2019. RESULTS: Seventy women with preeclampsia and 70 with pregnancy without this complication were studied. The neutrophil-lymphocyte ratio was significantly higher in women with preeclampsia (4.11 ± 2.76; 95%CI: 3.47-4.75), than in women with normal pregnancies (2.99 ± 1.6; 95%CI: 2.62-3.36; p = 0.004); which is similar for the platelet-lymphocyte ratio (117.61 ± 47.53, 95%CI: 106.48-128.24 vs 97.64 ± 43.67; 95%CI: 87.41-107.87; p = 0.006) and for the distribution of the width of the erythrocyte; (14.46 ± 1.9, CI95%: 14.02-14.9 vs 13.56 ± 1.38; CI95%: 13-13.72; p = 0.0002). None of these parameters was able to discriminate between patients with preeclampsia with or without severity criteria. A neutrophil-lymphocyte ratio ≥ 5.1 discriminates between women with a normal pregnancy and those with preeclampsia with or without severity criteria [area under the curve of 0.746, (95%CI: 0.664-0.827)], sensitivity 42%, specificity 91%, positive predictive value 82%, negative predictive value 60% and Odds Ratio 7.1 (95%CI: 2.7-18.6, p = 0.001). The platelet-lymphocyte ratio ≥ 113.4 can discriminate between women with a normal pregnancy and preeclampsia with or without severity criteria, with an area under the curve of 0.617 (95% CI 0.525-0.709). CONCLUSION: A neutrophil-lymphocyte ratio ≥ 5.1, and a platelet-lymphocyte ratio ≥ 113.1 are able to adequately discriminate between patients with normal pregnancy and those with preeclampsia with or without severity criteria.

A cross-sectional study to evaluate sonographic foetal humerus length for estimation of gestational age in normal singleton pregnancies at a tertiary care centre

Background: Accurate knowledge of gestational age of the foetus is essential for planning a timely and uneventful outcome. Biparietal diameter, head circumference, abdominal circumference and femur length reliably predict gestational age. The humerus length is not widely used as biometric parameter for determining the GA so the present study was done to estimate foetal gestational age by measuring humerus length between 18 to 36 weeks of normal singleton pregnancies and to compare humerus length with routine parameters.Methods: This was a hospital based descriptive cross-sectional study, 200 women with viable singleton pregnancy, with known LMP, between 18 weeks to 36 weeks of gestation were included. Various foetal measurements such as biparietal diameter, head circumference, abdominal circumference, femur length and humerus length were measured using electronic calipers on ultrasound. Data were statistically analyzed.Results: The mean humerus length at 18 weeks was 25.27±1.16 mm and at 36 weeks of gestation was 57.11±1.58 mm. Simple linear regression analysis shows a strongly significant linear relationship between humerus length and gestational age. Where, gestational age (weeks) Y= 0.5213 x humerus length (X) + 4.905; with high degree of correlation coefficient (R2 =0.9785 and P≤0.0001). When Compared with BPD, HC, AC and FL, humerus length also shows a linear correlation.Conclusions: The measurement of the humerus length can be an important additional parameter for estimating gestational age along with other parameters and can be used to predict the gestational age of fetuses in special circumstances.

Establishing Trimester-Specific Reference Ranges for Thyroid Hormones in Indian Women with Normal Pregnancy: New Light through Old Window

Introduction: Assessment of thyroid function duringpregnancy is important for assessing maternal and foetalwell being. However, the complex physiological alterationsoccurring during normal pregnancy cause thyroid hormonelevels to change. Hence, the interpretation of the thyroidprofile becomes difficult in pregnancy if normal referenceranges are not defined. Study objective was to determinetrimester specific reference ranges for thyroid hormone innormal pregnancy.Material and methods: Serum sample was collected from194 females in various trimester of normal intrauterine singlepregnancy and total T3, total T4 and TSH was determined.The results obtained were then analysed to determine gestationspecific thyroid hormone levels.Result: The normal ranges of thyroid hormone in first, secondand third trimesters during normal pregnancy in our studywere: total T3 (83.9-196.6, 86.1-217.4, 79.9-186 ng/dl), totalT4 (4.4-11.5, 4.9-12.2, 5.1-13.2 μg/dl) and TSH (0.1-2.7, 0.4-3.3, 0.5-3.8 IU/ml) respectively.Conclusion: The levels of thyroid hormones in pregnancynot only show characteristic changes from non pregnant statebut also vary with each trimester. Hence, trimester specificreference ranges for thyroid hormone need to be defined toensure correct interpretation of these tests.

Comparative Study on Serum Calcium Level in Preeclampsia Patients and Normal Pregnancy at Medical College & Hospital

Preeclampsia is a multi-system disorder with varied etiology. Serum calcium derangements have been reported in this group. Methods: The present comparative study included 50 cases with preeclampsia and 50 controls. History was taken from each patient and thorough clinical examination was done. Serum calcium levels were estimated and compared. Result: Serum calcium levels were lower in women with preeclampsia and the difference was statistically significant (p=0.000). Conclusion: Hypocalcaemia may have a role in pre-eclampsia.

Pattern and Prevalence of Thyroid Dysfunction in Nigerian Pregnant Females.

Introduction: Thyroid associated endocrinopathies are the second most common endocrine disorders, after diabetes mellitus in women and are more prevalent in women during their reproductive ages. Diagnosing thyroid disease in pregnancy can be difficult as the clinical signs and symptoms mimic those of pregnancy. This study was done to document the pattern and prevalence of thyroid dysfunction in Nigerian pregnant women. Materials and Methods: This was a cross sectional analytical study carried out on 264 Nigerian pregnant females and 75 aged matched healthy controls. Thyroid hormones, blood glucose, urinalysis and blood pressure were determined. Pregnant females were categorized into normal pregnancy, gestational hypertensive and gestational trimesters. Results: The mean age (SD) of participants with normal pregnancy was 29.82 (4.39 years). This was comparable with those with gestational hypertensive 31.78 (4.46 years) (p = 0.062). The mean ± SD of plasma levels of free T4 (0.37±0.16 ng/dl) in participants with normal pregnancy was significantly higher than those with gestational hypertensive (0.28±0.33 ng/dl), (p = 0.034). Intra trimester comparison of the participants with thyroid dysfunction showed subclinical hypothyroidism was present in 11.11%, 3.85% and 20.35% in first, second and third trimester respectively. Conclusion: Subclinical hypothyroidism is the most commonly documented of the thyroid dysfunctional status in Nigerian pregnant females.

Uncomplicated hyperemesis gravidarum does not alter the course of cardiovascular changes during pregnancy

The purpose of this prospective longitudinal study was to investigate the maternal cardiac haemodynamic and structural changes that occur in pregnancies with uncomplicated hyperemesis gravidarum in a selected Malaysian population. Nine women underwent serial echocardiography beginning at 12 weeks of gestation and throughout pregnancy at monthly intervals. Their echocardiograms were repeated at 6 and 12 weeks following delivery to reflect the pre-pregnancy haemodynamic state. Cardiac output was measured by continuous wave Doppler at the aortic valve. Interventricular septum thickness was determined by M- mode echocardiography and ventricular diastolic function by assessing flow at the mitral valve with Doppler recording. Cardiac output showed an increase of 32.9% at 36 weeks and maintained till 40 weeks of gestation. Heart rate increased from 79 ± 6 to 96 ± 8 beats/ min at 36 weeks. Stroke volume increased by 16.4 % at 40 weeks of gestation when compared to the baseline value. Systolic and diastolic blood pressure did not appreciably change but showed a lower reading during the mid-trimester period. Early inflow velocity of left ventricle did not show a rise while peak atrial velocity showed an increasing trend; thus the ratio of early inflow to peak atrial transport showed a declining trend from early pregnancy to term. End diastolic dimension of left ventricle and interventricular septum thickness showed an increased value at term. Uncomplicated hyperemesis gravidarum did not alter the haemodynamic changes throughout pregnancy and concur with established data for normal pregnancy.

Concentrations of cytokines in the mid-trimester amniotic fluid of normal pregnancy / 医学研究生学报

Objective The concentration of cytokines in the amniotic fluid ( AF) may reflect the immune state of maternal-fetal interface .This study aimed to investigate the level of inflammation -related cytokines in the mid-trimester AF of normal pregnant women. Methods This study included 263 pregnant women undergoing mid-trimester genetic amniocentesis , and all of them had normal pregnancy outcomes .Using MILLIPLEX MAP and Luminex, we measured the concentrations of interleukin IL-10, IL-1β, IL-6, monocyte chemotactic MCP-1, and tumor necrosis factor TNF-αin the AF collected from the women at 18-22 +6 weeks′gesta-tion.We analyzed the correlation of their concentrations with maternal age , gestational age , and fetal gender by rank sum test . Results The median concentrations of IL-10, IL-1β, IL-6, MCP-1, and TNF-αin AF at mid-trimester were 7.91, 0.97, 78.15, 1 135.57, and 8.47 pg/mL, respectively.The levels of IL-10 and IL-1βwere higher in the pregnancies with male fetuses than in those with female fetuses (8.54 and 1.18 pg/mL vs 7.72 and 0.85 pg/mL, P=0.043 and 0.008).Maternal age or gestational week at the mid-trimester exhibited no influence on the concentrations of the 5 cytokines. Conclusion The levels of IL-10, IL-1β, IL-6, MCP-1 and TNF-αremain stable in AF at mid-trimester and the former 2 are higher in pregnancies with male fetuses .

Evaluation of serum calcium and lipid profile in women with pre-eclampsia, eclampsia and normal pregnancy.

Introduction: Background & objective: Pre-eclampsia and eclampsia are the most common obstetrical complications during pregnancy. The objective of this work was to quantitate and find significance of serum calcium and lipid profile levels in pre-eclamptic and eclamptic pregnancy in comparison with normal pregnancy. Methods: Study includes 105 subjects divided into three groups. Estimation of Calcium, Triglycerides, Total-Cholesterol and HDL-C were analyzed by O-Cresolphthalein-Complexone, GPO-PAP, CHOD-PAP and Phosphotungstic acid precipitation method, using Erba Chem-5 plus semi-autoanalyser. Results: Mean serum calcium and HDL-C levels were significantly decreased in group-II and group-III in comparison to group-I,p<0.05. The mean triglyceride, VLDL-C and LDL-C levels were significantly increased in group-II as compared to group-I,p<0.05. There was no difference in the mean values of total-cholesterol between cases (group-II and group-III) and control (group-I),p>0.05; but the mean level of VLDL-C was higher in group-III in comparison to group-I,p<0.05. Non significant (p>0.05) difference was found in mean values of triglyceride and LDL-C in group-III cases in comparison to group-I. Interpretation & conclusion: Women having pre-eclampsia and eclampsia had low levels of serum calcium and disturbed lipid profile. These levels may have cause and effect relationship with these disorders.

Sonographic Evaluation of Cervical Length Changes during Normal Pregnancy

This study was aimed to establish reference values of cervical length in normal pregnancy. We studied a cross-sectional sample of 144 pregnant women by transabdominal sonography. The inclusion criteria were sonographic confirmation of gestational age; the absence of any risk factors for preterm birth; and uncomplicated pregnancy. Cervical length was measured in a straight line. Height; age and weight of patients were also obtained. There was a relationship between gestational age and cervical length; which could be described with a linear regression (R = 0.44; P0.05). Our study shows an increase in cervical length with gestational age. Reference ranges constructed for the whole gestational period could be more clinically applicable and useful than a single cut off value for more efficient prevention and management of preterm birth

Changes of plasma adrenomedullin and expression of adrenomedullin and its receptor in villus of normal early pregnancy / 医学研究生学报

Objective: To study the role of adrenomedullin(ADM) in normal early pregnancy. Methods: Plasma concentrations of ADM were measured in 30 normal early pregnancy and 10 non-pregnant women by radioimmunoassay. The expression of ADM?ADM mRNA and ADMR mRNA in villus of normal early pregnancy were determined by immunohistochemistry and in situ hybridization respectively. Results: The plasma concentration of ADM in normal early pregnancy was significantly higher than that of normal non-pregnant women (P

Placental apoptotic change in 2nd trimester and full-term of normal pregnancies / 대한산부인과학회잡지

OBJECTIVE: The study aims were to demonstrate apoptosis in the placenta of normal pregnancy, and to identify its change and quantify its incidence by gestational age. METHODS: Placenta samples were collected from 25 normal full-term pregnancies and 20 second trimester pregnancies undergoing termination due to medical and social reasons. Hematoxylin and eosin staining and TUNEL (terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling) staining were used to quantify the incidence of apoptosis and the electron microscopy was used to confirm it. Mann-Whitney U test and ANOVA test were used for statistical analysis. RESULTS: 1. Apoptosis was demonstrated by variable cytopathologic methods, and especially TUNEL staining and electron microscopy are found to be confirmatory methods. 2. In TUNEL staining, quantification of apoptosis was as follows: 2nd trimester (n=20) 1.05+/-0.69, full- term (n=25) 1.92+/-1.00. The incidence of apoptosis was significantly higher in full-term than in 2nd trimester (p0.05, Mann-Whitney U test). 4. There was no statistical significance in the incidence of apoptosis by maternal age, parity, cause of termination during 2nd trimester, and mode of delivery in each group. 5. In the electron microscopy, apoptotic cells were observed to have membrane blebbing, loss of microvilli, chromatin condensation and localization in the border of nuclear membrane, and cell shrinkage and increase in granularity. This method was conformatory in identifying apoptosis. CONCLUSION: Placental apoptosis increased significantly with increased gestational age, and this result suggests that it may play a role in the normal development and aging of the placenta.

Comparison of Placental Apoptosis in Normal Pregnancy, Preeclampsia and Intrauterine Growth Restriction / 대한산부인과학회잡지

OBJECTIVE: Aims of this study were to conclusively demonstrate apoptosis in the human placenta and to compare of placental apoptosis in normal pregnancy, preeclampsia and intrauterine growth restriction. METHODS: Placental samples obtained from 30 term, normal pregnancy, 30 pregnancies complicated intrauterine growth restriction, 30 pregnancies complicated preclampsia. The definition used to identify intrauterine growth restriction depends on fetal body weight ratio less than 10 percentile by ultrasonography. The definition used to identify preeclampsia depend on ACOG criteria. Light microscopy and polyclonal antibodies of Fas, Fas ligand, Bax, Bcl-2 were used to identify apoptosis. RESULTS: Apoptosis was conclusively demonstrated within placental tissue. Results of immunohis-tochemical analysis of Fas in the trophoblast of normal pregnancy, pregnancy induced hypertension and intrauterine growth restriction were negative of 86.7%, 26.7% and 13.3% respectively. Results of immunohistochemical analysis of Fas lgand in the trophoblast of normal pregnancy, pregnancy induced hypertension and intrauterine growth restriction were diffuse positive of 53.3%, 16.7% and 6.7% respectively. Results of immunohistochemical analysis of Bcl-2 in the trophoblast of normal pregnancy, pregnancy induced hypertension and intrauterine growth restriction were diffusely positive of 90.0%, 76.7% and 66.7% respectively. Results of immunohistochemical analysis of Bax in the trophoblast of normal pregnancy, preeclampsia and intrauterine growth restriction were diffuse positive of 40.0%, 40.0% and 50.0% respectively. CONCLUSION: Apoptosis and altered expression of Bcl-2 in trophoblast were conclusively demonstrated within placental tissue, suggesting that it may play a role in the normal development and aging of the placenta. Placental apoptosis and altered expression of Fas and Fas ligand in trophoblast might influence pathogenesis or pathophysiologic mechanism of preeclamsia and intrauterine growth restriction.

Cervical Length During Pregnancy in Korean Women as Assessed by Transvaginal Ultrasound: A Prospective Longitudinal Study / 대한산부인과학회잡지

OBJECTIVE: The aims of this study are to evaluate the longitudinal change in the cervix throughout pregnancy by transvaginal ultrasound and to establish a normogram of the cervical length in Korean pregnant women. METHODS: A prospective observational study was undertaken. Forty-eight women of singleton pregnancy without history of preterm delivery and medical or obstetrical complication were finally enrolled. Serial transvaginal ultrasound examination and the measurement of cervical length were performed at 12 weeks of gestation and every 4 weeks (until 28 weeks), every two weeks (until 36 weeks) and every week until delivery. ANOVA for repeated measures and paired t test were used for statistical analysis. RESULTS: The mean gestational age at delivery was 39.9 weeks. There was a significant quadratic correlation between gestational age and cervical length (y=-0.0038x(2)+0.1773x+1.6437, p<0.001). The cervical length was gradually increased until 24 weeks of gestation and then decreased during rest period of gestation. The measured values were distributed normally at each gestational age and the normogram of cervical length during pregnancy was presented in term of mean and standard deviation. There was no significant difference in cervical length between primipara and multipara. CONCLUSION: We presented serial measurements of cervical length throughout normal pregnancy. These values can be used as normative guidelines in assessment of cervical length during pregnancy.

A Case of Spontaneously Regressed Hyperreactio Luteinalis Occurred in Normal Pregnancy / 대한산부인과학회잡지

Hyperreactio luteinalis rarely occurs in normal single pregnancy. About 50 such cases have been published. It is usually occurs in trophoblastic disease. This case is a huge hyperreactio luteinalis that detected in gestational age 16 weeks. The patient delivered a normal female infant at 41th week of gestation without any mass related problems. The hyperreactio luteinalis was a benign condition in itself with normal spontaneous remission in two months after delivery. Also the level of elevated human chorionic gonadotropin became normal. The conservative management was appropriated. This case is noteworthy because it resulted in spontaneous regression without surgical intervention and conserved ovarian tissue.

A Case of Metastatic Choriocarcinoma following Preterm Delivery at 34th Week of Pregnancy / 대한산부인과학회잡지

Choriocarcinoma associated with a normal pregnancy is rare. Futhermore, choriocarcinoma coexistent with a viable pregnancy is even rarer and associated with a greater risk of hepatic and cerebral involvement. So timely diagnosis of the disease is important for successful treatment and aggressive diagnostic procedures may therefore warranted. The patient should be treated with primary intensive combination chemotherapy(EMA-CO) and the selective use of irradiation and surgical therapy. We experienced a case of metastatic choriocarcinoma of lung and kidney following preterm delivery at 34th week of pregnancy and so present it with brief review of literature.

If you get pregnant in the 90s what are the chances that you will have a normal pregnancy and a normal baby?

What are the chances of a pregnant woman having a normal pregnancy and a normal baby in the 90s. This is an assessment after regionalization of perinatal care was established in Quezon City in 1986 through the setting up of a Q.C. Perinatal Council. The Council is composed of the Perinatal Center, Philippine Childrens Medical Center, Quezon City General Hospital, Veterans Memorial Medical Center and Quirino Memorial Medical Center. One thousand consecutive, unselected pregnancies were followed up from the first trimester until delivery. Eight hundred sixty eight (86.8%) had a normal pregnancy and baby; one hundred seven (10.7%) had premature deliveries. There were 4 stillbirths, 9 neonatal deaths and 18 NICU admissions. The perinatal mortality rate was 13 per 1000 pregnancies. There were 32 who developed hypertensive complications of pregnancy. Chance of developing a normal pregnancy is 6 out of 10, an abnormal pregnancy is 2 out of 10 and ending in an abortion is 2 per 100.

A Case of metastatic choriocarcinoma diagnosed at 34th week of pregnancy / 대한산부인과학회잡지

Choriocarcinoma associated with a normal pregnancy is rare. Especially, choriocarcinoma coexistent with a viable pregnancy is even rarer and commonly presents with widespread metastatic disease. We experienced a patient at 34th week of pregnancy with dyspnea and sputum production due to pulmonary metastasis of choriocarcinoma. The serum B-hCG level was extremely elevated and the placenta had multifocal choriocarcinoma. After vaginal delivery, the patient was successfully treated with combination chemotherapy (EMA-CO). The patient is receiving follow up with monthly measurement of hCG values. We report one case of metastatic choriocarcinoma with viable pregnancy with review of literature.

Total Antioxidant Status in Maternal and Neonatal Plasma According to Delivery Type / 대한산부인과학회잡지

Antioxidants oppose the toxic actions of lipid peroxides and oxygen radicals, and they limit the amount of lipid peroxides formed. Women with normal pregnancies have an increase in oxidative stress and lipid peroxidation when compared with nonpregnant women. The antioxidants also increase progressively with advancing gestation, and the antioxidants in the fetus also increase with advancing gestation, especially during late gestation. The purpose of this study is to investigate the diefference of antioxidant status in maternal and neonatal plasma according to the delivery type. So, we investigated the status of antioxidant in the maternal and neonatal plasma when compared normal vaginal delivery with Cesarian section without labor. This study was done under the hypothesis that labor pain is originated from the hypoxic state of myometrium during uterine contraction. The number of women who were studied was total 56, 24 women were delivered by normal vaginal delivery and 32 women were done by Cesarean section without labor. The blood was sampled during active labor and postpartum 24 hour in the case of normal vaginal delivery, the women who were done Cesarean section being sampled before operation and 24 hours after operation. The neonatal blood was sampled from cord, birth 1 day and 3 day. The antioxidant levels were measured by Total Antioxidant Status (Randox Laboratory Ltd., UK) kit. The results were as follows. 1. The mean maternal plasma antioxidant status was not significantly different according to delivery types and not significantly different when compared antepartum with postpartum (vaginal delivery; antepartum: 1.54+/-0.31 mM/L, postpartum: 1.58+/-0.32 mM/L, Cesarean section; antepartum: 1.55+/-0.29 mM/L, postpartum: 1.56+/-0.33 mM/L). 2. The neonatal antioxidant status was not significantly different between the neonates who were born by vaginal delivery and the neonates who were born by Cesarean section. The neonatal plasma antioxidant status was increased progressively after birth (cord: birth 1 day: birth 3 day=1.46+/-0.25 mM/L: 1.59+/-0.25 mM/L: 1.79+/-0.37 mM/L). Therefore, labor pain was not seems to be significantly affect the maternal and neonatal plasma antioxidant status. And the neonatal antioxidant status was increased for adaptation to the external environment after birth.

Assessment of the coagulation activation in normal pregnancy and severe pre-eclampsia using D-dimer levels.

D-dimer was measured in 20 normal non-pregnant women, 20 normal pregnant women and 20 severe pre-eclampsia patients. D-dimer was found to be 182 + 63 ng/ml (mean+ SD) in non-pregnant women, significantly higher at 1,355+ 279 ng/ml in normal pregnant women and 1,928+ 625 ng/ml in severe pre-eclampsia. No abnormalities were detected in a screening coagulogram. It is concluded that D-dimer may-be more useful than a screening coagulogram. For the early detection of the activation of the coagulation system that occurs in normal pregnancy and becomes elevated in severe pre-eclampsia.

Measurements of Fetal Nuchal Skinfold Thickness in Normal Fetuses during Second Trimester / 대한산부인과학회잡지

OBFECTIVE: A nuchal skinfold thickness measurement of >or=6mm is widely used as anonivasive tool in screening fetuses with Down syndrome. The aim of this study is to obtainnormative data on the nuchal skinfold thickness in chromosomally normal fetuses duringsecond trimester. METHOD: Fetal nuchal skinfold thickness was measured in the suboccipitobregmaticplan as part of second trimester ultrasonography. Three hundred thirtyfive fetuses,confirmed to be without chromosomal abnormality through evaluation by amniocentesisand/or postnatal examination, were included. RESULT: The mean of measurements increased from 2.74mm to 5.30mm between 15Weeks and 26 weeks of gestation. The measurements of fetal nuchal kinfold thicknesscorrelated linearly with gestational age(y=-1.755+0.29, r(2)=0.406, p=0.0001). Fetal genderhad no influence on this measurement. In contrast to the fact that three of 271 fetuses at or=21 weeks showed nuchal thickness measurement of >or=6mm. CONCLUSION: During second trimester, measurements of fetal nuchal skinfold thicknessincreases as a function of gestational age in normal fetuses. There were no influence offetal gender and no ethnic difference from other countries in this measurement at 15~20weeks of gestation. However, measurements of fetal nuchal skinfold thickness >or=6mm asa screening tool for Down syndrome seems to be confined to fetuses at 15~20 weeks` gestation.