Mehmet Murat IŞIKALAN, Haççe YENİÇERİ, Ali ACAR

İkinci trimester nukal fold kalınlığının maternal karakteristikleri ve doğum ağırlığı ile ilişkisi

Amaç: Bu çalışmanın amacı ikinci trimesterdaki sağlıklı gebelerde maternal karekteristiklerin nukal fold kalınlığına etkisini ve nukal fold kalınlığı ile doğum ağırlığı arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntem: Bu prospektif longitudinal çalışmaya perinatoloji kliniğimize Temmuz - Eylül 2019 tarihleri arasında ikinci düzey ultrason taraması için başvuran 18-22 haftalık sağlıklı gebeler dahil edildi. Maternal karekteristikleri kaydedildikten sonra tüm gebelere anomali taraması yapıldı. Nukal fold kalınlığı ölçüldü. Hastalar doğuma kadar takip edildi. Bulgular: Toplam 115 gebe değerlendirildi. Gebelerin yaş ortalaması 29.1±4.0 idi. Nukal fold kalınlığı ortalaması 4.1±0.7 olarak belirlendi. Çoklu regresyon analizinde beden kitle indeksi, maternal yaş, fetal prezentasyon, fetal cinsiyet, parite ve plasenta lokalizasyonlarının nukal fold kalınlığı üzerine prediktif etkisi saptanmadı. Gebelik haftasıyla nukal fold kalınlığı arasında pozitif korelasyon saptandı. Ortalama doğum ağırlığı 3057±664 idi. Nukal fold kalınlığı ile doğum ağırlığı arasında anlamlı bir korelasyon saptanmadı. Sonuç: Kromozom anomalisi olmayan fetüslerde nukal fold kalınlığı maternal yaş, beden kitle indeksi, fetal cinsiyet, plasenta lokalizasyonu, fetal prezentasyon ve pariteden etkilenmemektedir. Nukal fold kalınlığı gebelik haftasıyla orantılı olarak artmaktadır. Nukal fold kalınlığı ile doğum ağırlığı arasında bir ilişki yoktur.

Relation of nuchal fold thickness with maternal characteristics and birth weight

Purpose: The aim of this study was to investigate the effect of maternal characteristics on nuchal fold thickness and the relationship between nuchal fold thickness and birth weight in healthy pregnant women in the second trimester. Materials and Methods: This prospective longitudinal study included healthy pregnant women at 18-22 weeks of gestation who applied to our perinatology clinic for a second level ultrasound scan between July - September 2019. After recording the maternal characteristics, anomaly screening was performed to all pregnant women. The nuchal fold thickness was measured. The patients were followed until delivery. Results: A total of 115 pregnant women were evaluated. The average age of pregnant women was 29.1 ± 4.0. The average nuchal fold thickness was determined as 4.1 ± 0.7. The predictive effect of body mass index, maternal age, fetal presentation, fetal gender, parity and placental location on nuchal fold thickness was not revealed in the multiple regression analysis. A positive correlation was found between gestational age and nuchal fold thickness. The average birth weight was 3057 ± 664. There was no significant correlation between nuchal fold thickness and birth weight. Conclusion: In fetuses without chromosomal anomaly, nuchal fold thickness is not affected by maternal age, body mass index, fetal gender, placental location, fetal presentation and parity. The nuchal fold thickness increases in proportion to the gestational age. No relation was found between nuchal fold thickness and birth weight

Keywords:

Birth weight, nuchal fold, nuchal translucency,

PDF

___

1. Hobbins JC, Lezotte DC, Persutte WH, DeVore GR, Benacerraf BR, Nyberg DA et al. An 8-center study to evaluate the utility of midterm genetic sonograms among high-risk pregnancies. J Ultrasound Med. 2003;22:33-8.
2. Hackmon R, Librach C, Burwick R, Rodrigues N, Farine D, Berger H. Do early fetal measurements and nuchal translucency correlate with term birth weight? J Obstet Gynaecol Can. 2017;39:750-6.
3. Gluckman P, Liggins G. Regulation of Fetal Growth. Fetal Physiology and Medicine: London, Elsevier. 1984;511-57.
4. Kalem Z, Ellibeş Kaya A, Bakırarar B, Namlı Kalem M. Fetal nuchal translucency: is there an association with birthweight and neonatal wellbeing? Turk J Obstet Gynecol. 2019;16:35-40.
5. Ben-Ami M, Perlitz Y, Mukary M, Peleg D. Nuchal fold thickness at 14-16 weeks' gestation as measured by transvaginal sonography. Ultrasound Obstet Gynecol. 2002;19:60-1.
6. Lee PR, Won HS, Chung JY, Shin HJ, Kim A. The variables affecting nuchal skin-fold thickness in mid- trimester. Prenat Diagn. 2003;23:60-4.
7. Agathokleous M, Chaveeva P, Poon LC, Kosinski P, Nicolaides KH. Meta-analysis of second-trimester markers for trisomy 21. Ultrasound Obstet Gynecol. 2013;41:247-61.
8. Goynumer G, Arisoy R, Turkmen O, Yayla M. Fetal nuchal skin-fold thickness during the 2nd trimester of pregnancy. J Obstet Gynaecol. 2015;35:111-4.
9. Salomon LJ, Alfirevic Z, Berghella V, Bilardo C, Hernandez-Andrade E, Johnsen SL et al. Practice guidelines for performance of the routine mid- trimester fetal ultrasound scan. Ultrasound Obstet Gynecol. 2011;37:116-26.
10. Cho JY, Kim KW, Lee YH, Toi A. Measurement of nuchal skin fold thickness in the second trimester: influence of imaging angle and fetal presentation. Ultrasound Obstet Gynecol. 2005;25:253-7.
11. Boucoiran I, Djemli A, Taillefer C, Rypens F, Delvin E, Audibert F. First-trimester prediction of birth weight. Am J Perinatol. 2013;30:665-72.
12. Weissmann-Brenner A, Weisz B, Lerner-Geva L, Gindes L, Achiron R. Increased nuchal translucency is associated with large for gestational age neonates in singleton pregnancies. J Perinat Med. 2011;39:305-9.
13. Pihl K, Sørensen TL, Nørgaard-Pedersen B, Larsen SO, Nguyen TH, Krebs L et al. First -trimester combined screening for Down syndrome: prediction of low birth weight, small for gestational age and pre- term delivery in a cohort of non-selected women. Prenat Diagn. 2008;28:247-53.
14. Kokanalı D, Coşkun B, Kokanalı, MK, Taşçı Y. Association between first-trimester aneuploidy markers and birth weight. Journal of Clinical and Analytical Medicine. 2017;8:125-8.
15. Özgan Çeli̇kel Ö, Aksoy N . Examination of the relationships between different birthweights and various gestational parameters. J Surg Med. 2018;2:55- 9.
16. Singh C, Biswas A. Impact of gestational age on nuchal fold thickness in the second trimester. J Ultrasound Med. 2014;33:687-90.
17. Kazemi K, Adibi A, Hovsepian S. Reference values of nuchal fold thickness in an Iranian population sample. J Res Med Sci. 2018;23:94.
18. Ellibeş Kaya A, Başbuğ A, Akar B, Bender A, Doğan O, Caliskan E. Nuchal fold nomogram and relationship with heart and central nervous system anomalies. Ege Klinikleri Tıp Dergisi. 2017;55:65-8.
19. Lee PR, Won HS, Chung JY, Shin HJ, Kim A. The variables affecting nuchal skin-fold thickness in mid- trimester. Prenat Diagn. 2003;23:60-4.
20. Yıldırım M, Köşüş A, Köşüş N, Sağlam H, Duran Erdolulu M. Prenatal tarama test parametreleri plasental lokalizasyon yada fetal cinsiyetten etkilenebilir. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2016;51-54.
21. Aagaard-Tillery KM, Flint Porter T, Malone FD, Nyberg DA, Collins J, Comstock CH et al. Influence of maternal BMI on genetic sonography in the FaSTER trial. Prenat Diagn. 2010;30:14-22.