THE SMALLER THAN EXPECTED 1ST-TRIMESTER FETUS IS AT INCREASED RISK FOR CHROMOSOME-ANOMALIES

被引:48
作者
DRUGAN, A
JOHNSON, MP
ISADA, NB
HOLZGREVE, W
ZADOR, IE
DOMBROWSKI, MP
SOKOL, RJ
HALLAK, M
EVANS, MI
机构
[1] WAYNE STATE UNIV,HUTZEL HOSP,DEPT OBSTET & GYNECOL,DIV REPROD GENET,DETROIT,MI 48201
[2] WAYNE STATE UNIV,HUTZEL HOSP,SCH MED,CTR FETAL DIAGNOSIS & THERAPY,DETROIT,MI 48201
[3] WAYNE STATE UNIV,HUTZEL HOSP,SCH MED,DEPT MOLEC BIOL,DETROIT,MI 48201
[4] WAYNE STATE UNIV,HUTZEL HOSP,SCH MED,DEPT GENET,DETROIT,MI 48201
关键词
CHROMOSOME ANOMALY; FIRST TRIMESTER; FETAL SIZE;
D O I
10.1016/0002-9378(92)91732-P
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: Intrauterine growth retardation associated with fetal chromosome anomalies is usually documented on ultrasonography late in the second trimester. However, we believe and attempt to document here that the impact of aneuploidy on fetal growth is evident much earlier (i.e., the aneuploid fetus may appear smaller than dates on ultrasonography even in the first trimester). STUDY DESIGN: For the population referred to our center for chorionic villus sampling from January 1988 to July 1991, we compared gestational age as calculated from the last menstrual period to that derived from fetal size as measured by crown-rump length. A cutoff of 7 days was chosen to select the study group. The remainder of our chorionic villus sampling population in which fetal size was expected was used as controls. We also divided those chorionic villus sampling patients by when a fetal death was observed by size. RESULTS: In the study period 3194 chorionic villus sampling procedures were performed and in 277 (8.7%) fetal length was smaller than expected by at least 7 days. Sixty (1.9%) chromosome anomalies were diagnosed by first trimester chorionic villus sampling in the study period. The frequency of chromosome anomalies was 4.3% in the study group and 1.7% in controls (p < 0.004). The more aberrant the karyotype on ''postmortem chorionic villus sampling,'' the greater the growth retardation tended to be. CONCLUSIONS: In our chorionic villus sampling population a fetal crown-rump length smaller than dates is associated with a significant increase in risk of chromosome anomalies. Moreover, the larger the size-dates discrepancy, the higher the possibility that the aneuploidy affecting that pregnancy is of the severe or lethal type.
引用
收藏
页码:1525 / 1528
页数:4
相关论文
共 12 条
  • [1] INTEGRATION OF THE TRANS-ABDOMINAL TECHNIQUE INTO AN ONGOING CHORIONIC VILLUS SAMPLING PROGRAM
    COPELAND, KL
    CARPENTER, RJ
    FENOLIO, KR
    LEDBETTER, DH
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1989, 161 (05) : 1289 - 1294
  • [2] GENETIC DIAGNOSIS IN THE 1ST TRIMESTER - THE NORM FOR THE 1990S
    EVANS, MI
    DRUGAN, A
    KOPPITCH, FC
    ZADOR, IE
    SACKS, AJ
    SOKOL, RJ
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1989, 160 (06) : 1332 - 1339
  • [3] EVANS MI, 1989, INTRAUTERINE GROWTH, P68
  • [4] JOHNSON M P, 1987, Fetal Therapy, V2, P109
  • [5] JOHNSON M P, 1989, Fetal Therapy, V4, P110
  • [6] A COMPARISON OF THE RELIABILITY OF THE ESTIMATED DATE OF CONFINEMENT PREDICTED BY CROWN-RUMP LENGTH AND BIPARIETAL DIAMETER
    KOPTA, MM
    MAY, RR
    CRANE, JP
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1983, 145 (05) : 562 - 565
  • [7] PETERSON JF, 1986, DAN MED B, V33, P296
  • [8] ROBINSON HP, 1975, BRIT J OBSTET GYNAEC, V82, P102
  • [9] EFFICIENT DIRECT CHROMOSOME ANALYSES AND ENZYME DETERMINATIONS FROM CHORIONIC VILLI SAMPLES IN THE 1ST TRIMESTER OF PREGNANCY
    SIMONI, G
    BRAMBATI, B
    DANESINO, C
    ROSSELLA, F
    TERZOLI, GL
    FERRARI, M
    FRACCARO, M
    [J]. HUMAN GENETICS, 1983, 63 (04) : 349 - 357
  • [10] SMAZAL SF, 1983, J ULTRAS MED, V2, P147