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First-trimester growth patterns of aneuploid fetuses

G Schemmer1, R J Wapner, A Johnson

  • 1Jefferson Medical College, Thomas Jefferson University, Department of Obstetrics and Gynecology, Philadelphia, PA 19107, USA.

Prenatal Diagnosis
|February 1, 1997
PubMed
Summary

First-trimester growth restriction is linked to specific fetal aneuploidies like trisomy 18 and 13. Early growth rate, not just crown-rump length, helps identify these chromosomal abnormalities.

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Area of Science:

  • Prenatal genetics and diagnostics
  • Fetal development and growth assessment

Background:

  • First-trimester growth restriction has been observed in some aneuploid pregnancies.
  • Understanding early fetal growth patterns in chromosomal abnormalities is crucial for diagnostic advancements.

Purpose of the Study:

  • To investigate the association between first-trimester fetal growth parameters and aneuploidy.
  • To compare crown-rump lengths (CRLs) and growth rates in chromosomally abnormal versus euploid fetuses.

Main Methods:

  • Comparison of CRLs and growth rates between 196 aneuploid fetuses and 1929 euploid controls.
  • Analysis included fetuses with trisomy 18, trisomy 13, triploidy, trisomy 21, sex chromosome trisomies, and 45,X.
  • Evaluation of growth rate versus single CRL measurement as discriminators for aneuploidy.

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Main Results:

  • Significantly reduced mean CRLs and growth rates were found in fetuses with trisomy 18, trisomy 13, and triploidy (P < 0.05).
  • Fetal growth rate, using a fifth percentile cut-off, was a better indicator than CRL alone for identifying these aneuploidies.
  • No significant growth reductions were observed in fetuses with trisomy 21, sex chromosome trisomies, or 45,X.

Conclusions:

  • Fetal growth restriction can manifest in the first trimester due to underlying chromosomal abnormalities.
  • This growth restriction is attributed to intrinsic fetal factors, not delayed ovulation.
  • These findings are vital for refining first-trimester serum screening protocols.