MANEJO DEL FETO CON TRANSLUCENCIA NUCAL AUMENTADA
DOI:
https://doi.org/10.18004/anales/2016.049(02)49-068Palabras clave:
trasnlucencia nucal, cromosomopatías, ecografía semana 11 – 13+6, cribado, ParaguayResumen
La medida de la Translucencia Nucal (TN) es un método ampliamente aceptado en el cribado de anomalías cromosómicas. Su técnica está bien descrita y estandarizada, refiriéndose como aumentada cuando la medida está por encima del percentil 95.
Su combinación con la edad materna, hueso nasal y marcadores bioquímicos, pueden detectar aproximadamente el 90% de los fetos con Trisomía 21 y en forma aislada el 70% con una tasa de falsos positivos del 5%.
Se han atribuido como causa de su aumento a la falla cardíaca, alteración en la composición de la matriz extracelular, hipoproteinemia fetal, congestión venosa en cabeza y cuello, fallo del drenaje linfático, infecciones congénitas o anemia fetal.
Su aumento se ha asociado a abortos o muertes fetales, anomalías fetales mayores y entre ellas las cardíacas o bien Síndromes genéticos, asociado a infecciones, macrosomía e incluso retraso en el desarrollo, por lo que no solamente se circunscribe a las alteraciones cromosómicas. De ahí radica su importancia de conocer el manejo de estas pacientes, en especial si el cariotipo es normal.
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