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Panminerva Medica 2000 March;42(1):39-43

lingua: Inglese

Fetuses with cystic hygroma. A retrospective study

Musone R., Bonafiglia R. *, Menditto A., Paccone M., Cassese E., Russo G., Balbi C.

From the Department of Obstetrics and Gynecology, Second University of Naples, Italy
* Division of Obstetrics and Gynecology Civil Hospital, Caserta, Italy


Background. The aim of ­this ­study is to ana­lyse sev­er­al the­o­ries of path­o­gen­e­sis of cys­tic hygro­ma, its cor­re­la­tion ­with chro­mo­so­mal abnor­mal­ities and the indi­ca­tors of ­poor or ­good prog­no­sis.
Methods. Experimental ­design: This is a ret­ro­spec­tive ­study ­that eval­u­ates all cas­es of cys­tic hygro­ma ­seen dur­ing the ­four-­year peri­od ­from January 1994 to December 1997. Setting: This ­study was per­formed in the cen­ter of pre­na­tal diag­no­sis of insti­tu­tion­al hos­pi­tal in Caserta. Patients: All cas­es of fetus­es ­with cys­tic hygro­ma ­were exam­ined in 2100 preg­nant ­female who vis­it­ed the ambu­lal­o­ry. Interventions: The mod­al­i­ty of diag­no­sis of ­this pathol­o­gy and the pres­ence of abnor­mal mater­nal ser­um lev­els of ­alpha-fet­o­pro­tein, ­human chor­ion­ic gon­a­dot­ro­pin and uncon­ju­gat­ed estri­ol ­were eval­u­at­ed. Moreover, the pres­ence of kar­yo­type abnor­mal­ities or oth­er non chro­mo­so­mal abnor­mal­ities ­were ­also eval­u­at­ed. Prognostic indi­ca­tors ­such as the pres­ence of sep­tae ­seen by sonog­ra­phy ­were exam­ined.
Results. Nine fetus­es ­with cys­tic hygro­ma ­were diag­nosed son­o­graph­i­cal­ly. Septae ­were iden­ti­fied in six cas­es. Chromosomal abnor­mal­ities ­were ­found in ­five cas­es. Two cas­es pre­sent­ed Turner’s syn­drome and one ­case Downs’ syn­drome. There ­were two cas­es ­with asso­ciat­ed anom­a­lies. The amni­ot­ic ­fluid ­alpha-fet­o­pro­tein (AFP) lev­els ­were ­high in all cas­es.
Conclusions. Cystic hygro­ma is a mal­for­ma­tion of the lym­phat­ic ­system ­that is diag­nosed by ultra­sound ­very ­well ­from the ­first quar­ter of preg­nan­cy. It is fre­quent­ly asso­ciat­ed ­with chro­mo­so­mal and non chro­mo­so­mal abnor­mal­ities. The pres­ence of sep­tae in it and amni­ot­ic ­fluid AFP lev­els are prog­nos­tic indi­ca­tors.

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