Document Detail

Temporal relationship between increased nuchal translucency and enlarged jugular lymphatic sac.
MedLine Citation:
PMID:  17012445     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To study the relationship between the volume of the jugular lymphatic sacs and nuchal translucency thickness in fetuses with increased nuchal translucency with advancing gestation. METHODS: Seventy-four fetuses with a nuchal translucency greater than the 95th percentile were examined weekly between 11 and 17 weeks of gestational age. The fetal neck region was studied by ultrasonography, followed by measurement of nuchal translucency and jugular lymphatic sacs. The measurements were analyzed using multilevel analysis. In case of termination of pregnancy postmortem examination was performed. RESULTS: In 40 euploid fetuses and 34 aneuploid fetuses, 159 measurements of jugular lymphatic sac volume and nuchal translucency thickness were analyzed. The volume of the jugular lymphatic sacs and gestational age showed a quadratic relation, which differed between euploid and aneuploid fetuses (P < .01). The maximum volumes were larger and present longer in fetuses with aneuploidy than in euploid fetuses (P < .01). In case of a cardiac anomaly, jugular lymphatic sac volume was larger than in cardiac normal fetuses (nonsignificant). Furthermore, the development of jugular lymphatic sac volume and increased nuchal translucency were related, whereby an increase of the nuchal translucency preceded enlargement of the jugular lymphatic sacs (P < .001). In each fetus an increase in jugular lymphatic sac volume was followed by a decrease with advancing gestation. The gestational age at maximum jugular lymphatic sac volume differed between fetuses, indicating a fetus-specific pattern. Nuchal translucency development showed a similar pattern. Postmortem examination confirmed distension of the jugular lymphatic sacs in all cases. CONCLUSION: Increased nuchal translucency is associated with abnormal lymphatic development, in which nuchal translucency enlargement precedes enlargement of jugular lymphatic sacs on ultrasound examination. Aneuploid fetuses have a more disturbed lymph angiogenesis. LEVEL OF EVIDENCE: III.
Mireille N Bekker; Jos W R Twisk; Margot M Bartelings; Adriana C Gittenberger-de Groot; John M G van Vugt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  108     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-02     Completed Date:  2006-10-27     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  846-53     Citation Subset:  AIM; IM    
Department of Obstetrics, VU University Medical Center, Amsterdam, the Netherlands.
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MeSH Terms
Abortion, Eugenic
Gestational Age
Lymphatic Vessels / abnormalities,  embryology*,  ultrasonography
Neck / ultrasonography
Nuchal Translucency Measurement*
Pregnancy Trimester, First
Pregnancy Trimester, Second
Ultrasonography, Prenatal

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