26 nov. 2009 EVALUAREA ECOGRAFICĂ, BIDIMENSIONALĂ, A HIPOPLAZIEI OSULUI MAXILAR LA FEŢII CU TRISOMIE 21 IN SĂPTĂMÂNILE 11-14 DE SARCINĂ.
Bogdan Botezatu, Bogdan Marinescu
Spitalul Clinic de Obstetrica si Ginecologie “Prof. Dr. Panait Sîrbu”, Bucureşti
Rezumat
Scopul lucrarii este acela de a studia hipoplazia osului maxilar, adică regiunii centrale a feţei, la fetuşii cu trisomie 21 în săptămânile de gestaţie 11+0 to 13+ 6 prin masuratori bidimensionale ale osului maxilar şi in final sa compară rezultatele obţinute cu cele ale altor studii123.
Materiale si metode s-a făcut o măsurare bidimensională a maxilarului fetal inainte de cariotipare in săptămâninile 11-13,6 de gestaţie dintre care 10 s-au dovedit a avea trisomie 21 si 41 cu cariotip normal. S-au folosit in evaluare doua diametre primul transversal intre rami mandibulari si al doilea fiind lungimea, diametrul sagital al maxilarului.
Rezultate In grupul fetuşilor cu cariotip normal lungimea maxilarului a crescut liniar cu CRLul astfel de la 4,7 mm la CRL de 47mm până la 8 mm la un CRL de 84 in cadrul feilor cu trisomie 21 lungimea maxilarului era semnificativ mai mica ( in medie cu 0,8mm, si un , P < 0.005)
Concluzii intr-o proporţie importantă feţii cu trisomie 21 prezinta o hipoplazie a zonei centrale faciale corespunzator maxilarului inclusiv in saptamanile 11 + 0 to 13 + 6 de gestaie.
Abstract – Bidimensional evaluation of maxilla hypoplasia in fetuses with trisomy 21 at 11 -14 weeks of gestation
Objective To investigate the mid-facial hypoplasia of fetuses with trisomy 21 at 11 +0 to 13+ 6 weeks of gestation, by bidimensional evaluation of the maxilla, and compare the results with other studies123
Methods A 2D mesurement of the fetal maxilla was obtained before fetal karyotyping at 11 + 0 to 13 + 6 weeks of gestation in 10 fetuses that were subsequently found to have trisomy 21 and in 41 fetuses subsequently found to be chromosomally normal. Two diameters were use first transverse views of the fetal face and to demonstrate the maxilla, the adjacent rami of the mandible and the nasal bones and the maxillary length.
Results In the chromosomally normal group the maxillary length increased linearly with crown–rump length (CRL) from 4,7mm at a CRL of 47 mm to 8mm at a CRL of 84 mm and in the trisomy 21 fetuses the length was significantly smaller than normal (mean difference= “0.8 mm, P < 0.005)
Conclusions In a high proportion of fetuses with trisomy 21 there is sonographic evidence of mid-facial hypoplasia at 11 + 0 to 13 + 6 weeks of gestation.
Keywords: ultrasonography, first-trimester screening, maxila, trisomy 21.