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Boutot M, Yardin C, Martin R, Bourthoumieu S, Aubard V, Martin S, Aubard Y, Coste-Mazeau P. Follow-up of increased nuchal translucency: Results of a study of 398 cases. J Gynecol Obstet Hum Reprod 2022; 51:102482. [DOI: 10.1016/j.jogoh.2022.102482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 08/06/2022] [Accepted: 10/05/2022] [Indexed: 11/08/2022]
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Kagawa K, Takahashi H, Nagayama S, Horie K, Takahashi K, Baba Y, Ogoyama M, Suzuki H, Usui R, Ohkuchi A, Matsubara S. Long-term outcome of fetus with ameliorated cystic hygroma. Taiwan J Obstet Gynecol 2021; 60:874-877. [PMID: 34507664 DOI: 10.1016/j.tjog.2021.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2020] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Cystic hygroma often ameliorates or disappears with pregnancy progression. Fetuses/neonates with amelioration, when without chromosomal or major structural abnormality, generally show a favorable outcome at birth. The present study was aimed to clarify the short/long-term outcomes of fetuses/neonates with the amelioration of cystic hygroma during pregnancy. MATERIAL AND METHODS This was a retrospective observational study. We focused on fetuses with cystic hygroma managed in our institute between January 2006 and June 2019. The infants were followed by pediatricians (neonatologist, pediatric cardiologist, and pediatric neurologist) and pediatric outcomes were retrieved from the medical records up to 3 years old. RESULTS One hundred and seven fetuses with cystic hygroma were included. Of the 107, cystic hygromas ameliorated in 31 fetuses (31/107: 29%). Of the 31, there were 26 livebirths. Half (n = 13) of the 26 fetuses had a good outcome, whereas the remaining half (n = 13) had abnormalities. Various abnormalities were detected in their infancies. A nuchal thickness (diameter of hygroma) of ≥5 mm was significantly correlated with abnormalities (P = 0.047). CONCLUSION Physicians should pay attention to fetuses/neonates with ameliorated cystic hygroma. Of those, special attention should be paid to fetuses/neonates with a nuchal thickness at diagnosis ≥5 mm.
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Affiliation(s)
- Keiko Kagawa
- Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, Japan
| | - Hironori Takahashi
- Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, Japan.
| | - Shiho Nagayama
- Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, Japan
| | - Kenji Horie
- Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, Japan
| | - Kayo Takahashi
- Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, Japan
| | - Yosuke Baba
- Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, Japan
| | - Manabu Ogoyama
- Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, Japan
| | - Hirotada Suzuki
- Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, Japan
| | - Rie Usui
- Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, Japan
| | - Akihide Ohkuchi
- Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, Japan
| | - Shigeki Matsubara
- Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, Japan
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[Contribution of array CGH in the management of fetal nuchal translucency]. ACTA ACUST UNITED AC 2019; 48:174-180. [PMID: 31634590 DOI: 10.1016/j.gofs.2019.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Increased nuchal translucency and cystic hygroma have a neonatal prognosis, when the karyotype is normal, which depends on the findings during the medical follow-up. Array comparative genomic hybridization (aCGH) has been systematically included in this follow-up by prenatal diagnosis teams. There are no guidelines and little information on the advantages of carrying out this test systematically. The aim of our study is to evaluate the contribution of the aCGH in the medical follow-up. METHODS Fifty-one patients were included during 18 months and followed till the end of their pregnancy in prenatal diagnosis centers in Brest and Amiens. Inclusion criterion was a nuchal translucency above 3,5mm on the first trimester ultrasound. A fetal DNA ChromoQuant and aCGH analysis on chorionic villi sampling, and an ultrasound at 18 weeks of gestation were performed during the follow-up. RESULTS The aCGH was decisive in only 2 cases. The ultrasound at 18 weeks gestation seemed to be more sensible in the detection of an abnormality. When the aCGH relieved an abnormality, the ultrasound permitted already to detect the presence of a deformity. In 10 cases, the aCGH could not be interpreted on the chorionic villi sampling. In 9 cases, an amniocentesis was performed in order to obtain this result. CONCLUSION Given the results of this study, the aCGH was rarely determinant or decisive on the realization of a therapeutic abortion. These elements make us reflect on the necessity of maintaining this test before 14 weeks of gestation or propose it as a second-line test after the ultrasound shows signs at 18weeks of gestation.
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Aymelek HS, Oğur G, Tosun M, Abur Ü, Altundağ E, Çelik H, Kurtoğlu E, Malatyalıoğlu E, Akar ÖS, Alper T. Genetic Burden and Outcome of Cystic Hygromas Detected Antenatally: Results of 93 Pregnancies from a Single Center in the Northern Region of Turkey. J Med Ultrasound 2019; 27:181-186. [PMID: 31867191 PMCID: PMC6905260 DOI: 10.4103/jmu.jmu_114_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 02/15/2019] [Accepted: 02/26/2019] [Indexed: 11/30/2022] Open
Abstract
Objective: Genetic burden, fetal malformations, and fetal outcomes of 93 fetuses with cystic hygroma (CH) are reported from a single center in Turkey. Patients and Methods: Pregnancies, having a diagnosis of fetal CH, detected between January 2010 and October 2016, were included in the study except fetuses having increased nuchal translucency. Fetal age/gender, maternal age, the age of pregnancy, types of fetal malformations, karyotype, and outcomes were evaluated. Results: The average gestational age was 16.2 weeks. Nearly 47% of the pregnancies had multiple congenital anomalies, of which 58% had a chromosomal anomaly. Chromosomal anomaly rate was 68.2% in patients with hydrops fetalis. Aneuploidies were major chromosomal defects. All trisomies were of regular type except one with Robertsonian translocation (46, XY, +13, rob[13;14][q10;q10]). Seventy-four percentage pregnancies were terminated due to either fetal/karyotype anomaly. Conclusion: Characteristics of fetal CH were similar in different ethnical backgrounds. Aneuploidy is the dominant chromosomal constitution of fetal CH. Little information was known about the genes involved. Gene dosage effect implies that fetal CH is a complex genetic situation involving multiple genes interactions. For proper genetic counseling, each fetus with CH should be karyotyped, and fetal ultrasound examination should be performed. In the case of normal chromosome set, application of aCGH should be considered.
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Affiliation(s)
- Huri Sema Aymelek
- Department of Medical Genetics, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
| | - Gönül Oğur
- Department of Medical Genetics, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
| | - Miğraci Tosun
- Department of Gynecology-Obstetrics, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
| | - Ümmet Abur
- Department of Medical Genetics, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
| | - Engin Altundağ
- Department of Medical Genetics, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
| | - Handan Çelik
- Department of Gynecology-Obstetrics, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
| | - Emel Kurtoğlu
- Department of Gynecology-Obstetrics, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
| | - Erdal Malatyalıoğlu
- Department of Gynecology-Obstetrics, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
| | - Ömer Salih Akar
- Department of Medical Genetics, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
| | - Tayfun Alper
- Department of Gynecology-Obstetrics, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
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Chen CP, Chang SY, Lau HS, Chen SW, Lai ST, Chuang TY, Lee MS, Wang W. First-trimester cystic hygroma and omphalocele in a fetus with Turner syndrome. Taiwan J Obstet Gynecol 2019; 57:763-764. [PMID: 30342669 DOI: 10.1016/j.tjog.2018.08.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2018] [Indexed: 11/25/2022] Open
Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Biotechnology, Asia University, Taichung, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Shu-Yuan Chang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Hui-Shuan Lau
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shin-Wen Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shih-Ting Lai
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Tzu-Yun Chuang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Meng-Shan Lee
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wayseen Wang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Bioengineering, Tatung University, Taipei, Taiwan
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[Transabdominal chorionic villus sampling using biopsy forceps or needle: pregnancy outcomes by technique used]. ACTA ACUST UNITED AC 2013; 43:713-20. [PMID: 24268873 DOI: 10.1016/j.jgyn.2013.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 10/10/2013] [Accepted: 10/16/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To compare pregnancy outcomes after transabdominal chorionic villus sampling using biopsy forceps or needle. MATERIALS AND METHODS Retrospective bicentric study including all women who had a transabdominal chorionic villus sampling between 2005 and 2009 (172 using biopsy forceps and 160 using needle). The primary endpoint was the rate of fetal loss, after excluding medical abortion due to the result of the biopsy. The secondary endpoint was the rate of premature rupture of the membrane. All cases were reviewed to try to determine the responsibility of the biopsy. RESULTS The pregnancy outcomes were not different between the two groups: 4 (4.4%) fetal losses in the biopsy forceps group and 6 (7.4%) in the needle group (P=0.52). Only one case (1.2%) of fetal loss can be attributed to the biopsy, using a needle, and none (0%) following a forceps biospy (P=0.29). The rate of premature rupture of the membrane was comparable in the two groups. CONCLUSION The pregnancy outcomes following chorionic villus sampling using a biopsy forceps or a needle seem comparable.
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Significance of septa in first trimester increased nuchal translucency thickness. J Med Ultrason (2001) 2013; 41:51-6. [DOI: 10.1007/s10396-013-0464-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 04/26/2013] [Indexed: 10/26/2022]
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Lajeunesse C, Stadler A, Trombert B, Varlet MN, Patural H, Prieur F, Chêne G. [First-trimester cystic hygroma: prenatal diagnosis and fetal outcome]. ACTA ACUST UNITED AC 2013; 43:455-62. [PMID: 23747217 DOI: 10.1016/j.jgyn.2013.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 04/13/2013] [Accepted: 04/26/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To describe the ultrasonographic (US) and fetal karyotyping data of fetuses with cystic hygroma diagnosed in the first trimester. PATIENTS & METHODS Maternal and fetal data of 69 consecutive fetal cystic hygroma were analysed between 2002 and 2009. RESULTS The mean size of the cystic hygroma was 6.3 mm ± 2.4 mm. US abnormalities were present in 54% of cases (37/69) (essentially hydrops fetalis in 45%), with an unfavourable prognosis (P=0.006). Chromosomal abnormalities were present in 53% of cases (36/68) (including 44% of Down syndrome). The rate of unfavourable outcome of pregnancy was 71% of cases (49/69) and was associated with the oldest mothers (P=0.011). In the chromosomally normal pregnancies, there were 59% (19/32) fetus with no apparently abnormalities. Among these 19 children, 13 have been followed up until an average age of 5 years and a half, the infant development was strictly normal. DISCUSSION AND CONCLUSION The current results suggest to look for the poor prognosis data: nuchal thickness superior to 6 to 6,5 mm, presence of a hydrops fetalis and/or US abnormalities, fetal karyotyping and/or US evolution of cystic hygroma.
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Affiliation(s)
- C Lajeunesse
- Département de gynécologie-obstétrique & médecine de la reproduction, université de Saint-Étienne, Jean-Monnet, CHU de Saint-Étienne, avenue Albert-Raimond, 42023 Saint-Étienne, France
| | - A Stadler
- Département de gynécologie-obstétrique & médecine de la reproduction, université de Saint-Étienne, Jean-Monnet, CHU de Saint-Étienne, avenue Albert-Raimond, 42023 Saint-Étienne, France
| | - B Trombert
- Département de santé publique, université de Saint-Étienne, Jean-Monnet, CHU de Saint-Étienne, 42023 Saint-Étienne, France
| | - M N Varlet
- Département de gynécologie-obstétrique & médecine de la reproduction, université de Saint-Étienne, Jean-Monnet, CHU de Saint-Étienne, avenue Albert-Raimond, 42023 Saint-Étienne, France
| | - H Patural
- Département de pédiatrie, université de Saint-Étienne, Jean-Monnet, CHU de Saint-Étienne, 42023 Saint-Étienne, France
| | - F Prieur
- Département de génétique, université de Saint-Étienne, Jean-Monnet, CHU de Saint-Étienne, 42023 Saint-Étienne, France
| | - G Chêne
- Département de gynécologie-obstétrique & médecine de la reproduction, université de Saint-Étienne, Jean-Monnet, CHU de Saint-Étienne, avenue Albert-Raimond, 42023 Saint-Étienne, France.
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