| Objective:To study whether the size of cistern magna measured by ultrasound has correlation with gestational age (GA) and biparietal diameter;to evaluate whether the size of fetal cisterna magna has gender difference between male fetuses and female fetuses. To study whether isolate mega cistern magna has gender difference and to observe the pregnancy outcome of the fetuses with enlarged cistern magna.Materials and methods1. Study population(1) From April2010to February2012four hundred and forty-two singleton pregnancy women acceped routine fetal sonographic examinations during the second trimester and the third trimester in qilu hospital.These pregnant women were heathy and had accurate menstrual cycle,gestational age was determined on the basis of the last menstrual period and without complicated pregnancy.The age ranged from20to42years old, the mean age is29.2. The gestational weeks ranged from18to39weeks,the mean week is28.The ultrbiparietal diameter,head circumference, abdominal circumference and femur length measured by ultrasound consistent with gestational age.(2) During April2008to February2012,765singleton pregnancy women acceped routine fetal sonographic examinations during the second trimester and the third trimester,the pregnancy women were heathy and had accurate menstrual cycle,gestational age was determined on the basis of the last menstrual period and without complicated pregnancy. The age ranged from22to44years old, the mean age is28.6. The gestational weeks ranged from28to39weeks,the mean week is32. Retrospective analysis109fetuses considered enlarged cisterna magna by fetal sonographic examinations and meanwile accepted fetal MRI.(3)Among the fetuses accepted routine fetal sonographic examinations during April2010and February2012, Retrospective analysis121fetuses considered enlarged cisterna magna by fetal sonographic examinations. The gestational weeks ranged from28to40weeks,the mean week is33.2. Study methods:We measured442cases of fetal cisterna magna randomly by routine fetal sonographic examinations, the gestational weeks ranged from18to39weeks, measured fetal biparietal diameter,meanwhile In order to study needs, wo should observe and record the sex of the fetus;Make the fetuses grouped. Different groups of fetal cisterna magna anteroposterior diameter was determined by analysis of variance,then Conducted pairwise comparisons among each group mean by LSD test. The relationship between gestational age and cistern magna was determined by Pearson regression anaiysis;Meanwhile the relationship between biparietal diameter and cistern magna was determined by Pearson regression anaiysis; Comparison with the anteroposterior diameter of the cisterna magna of different gender fetus determined by u test; Utilize ultrasound(US) to screen fetuses with mega cistern magna,and the fetuses suspected mega cistern magna by US accepted fetal head MRI in the near future.The fetuses with mega cisterna magna diagnosed by ultrasound and MRI meanwhilely were undertaken gender classification,the proportion of fetuses with mega cisterna magna in different gender applied x2analysis.p<0.001was considered to have statistical significance.The outcome and prognosis of fetuses with enlarged cistern magna conduct telephone follow-up.Results:(1) We found thatl-5groups of fetal anteroposterior diameter of cisterna magna have significant statistically difference (P<0.05),while6～11groups have no statistically difference (P>0.05).(2)The size of fetal cisterna magna measured by ultrasound has good linear correlation with gestational age(r=0.907, P<0.05) and biparietal diameter(r=0.899, P<0.05) during18～27gestational age,while it has no linear correlation with gestational age and biparietal diameter after27gestational age (P>0.05).(3) In the fetuses with28～39gestational age,The mean value of cisterna magna in136normal male fetuses is9.03±1.28mm,while The mean value of cisterna magna in125normal female fetuses is8.54±0.84mm, there was significant gender difference between male and female cisterna magna measurement by mean value t analysis (u=5.924P<0.001).(4) There was significant gender difference in fetuses with mega cisterna magna by appliying statistical treatment.(5) The abortion rate of non-isolated mega cisterna magna is50%, the rate of developmental delay is50%, All isolated mega cisterna magna that followed up have a good prognosis(100%).Conclusions:(1) The cize of the fetal cisterna magna increase throughout pregnancy during18～27gestational weeks. The cize of the fetal cisterna magna has no significant change during pregnancy afert27gestational weeks.(2)There was significant linear correlation between the cisterna magna and the gestational weeks and the biparietal diameter during18～27gestational weeks, there was no correlation between the cisterna magna and the gestational weeks and the biparietal diameter afert27gestational weeks.(3)Generally the cize of the male fetal cisterna magna is more larger than that of the female fetal during28～39gestational weeks.(4) There are significant gender differences among the fetuses with enlarged cisterna.(5)The fetuses with non-isolated ECM have a bad prognosis,while the fetuses with isolated ECM have a good prognosis.Main Innovative Points1. The study base on the clinical, we study gender differences of fetal cisterna magna.2. To study whether isolate mega cistern magna has gender difference... |
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