2020, Number 2
Next >>
Medicentro 2020; 24 (2)
Utility of fetal thymus measurement in the diagnosis of congenital anomalies and obstetric diseases
González HL, Herrera MM, Estrada LK, Hernández MV, Ley VL, Oliva BHJ
Language: Spanish
References: 25
Page: 229-249
PDF size: 630.29 Kb.
ABSTRACT
Introduction:
the interest in sonographic visualization of the fetal thymus is related
to its important immunological function, the diagnostic possibilities offered by high
resolution ultrasound scanners, and the increased reporting of possible conditions
during the ge station process.
Objective:
to determine the frequency of fetal thymic hypoplasia in pregnant
women with genetic risks and to relate it to the presence of fetal defects, previous
risk factors and the appearance of adverse obstetric effects.
Methods:
we con ducted a prospective descriptive study consisting of the
ultrasound evaluation of the fetal thymus by means of the thymic thoracic ratio in
221 pregnant women who come to referral services of the Provincial Center of
Medical Genetics, because they presente d increased genetic risk for heart
disease.
Results:
sixteen fetuses were found with a thymic thoracic ratio less than or equal
to 0.30, which was used as the criterion for thymic hypoplasia in this study: four
with heart diseases, four with chromosomal di seases, one with isolated structural
malformation, two with preeclampsia, one with delayed intrauterine growth, one
preterm and one fetal death. The reference reasons with the highest proportion of
positivity were: increased nuchal translucency and image o f suspected congenital
cardiopathy in screening ultrasound.
Conclusions:
determination of the thymic thoracic ratio allowed us the diagnosis
of thymic hypoplasia, both in the second and third trimester of pregnancy. This type
of research is relevant becau se it helps to identify: congenital defects, risk factors
and adverse obstetric effects.
REFERENCES
Mingueneau M, Kreslavsky T, Gray D, Heng T, Cruse R, Ericson J, et al . The transcriptional landscape of αβ T cell differentiation. Nat Immunol. 2013;14 :619 32.
Yui MA, Rothenberg EV. Developmental gene networks: a triathlon on the course to T cell identity. Nat Rev Immunol. 2014 Jul. 25;14:529 45.
Tangshewinsirikul C , Panburana P Sonographic measurement of fetal thymus size in uncomplicated singleton pregnancies. J Clin Ultrasound 2017 Mar. 4;45(3):150 9.
Tonni G , Rosignoli L , Cariati E , Martins WP , Miyague AH Bruns RF , et al Fetal thymus: visualization rate and volume by integrating 2D and 3D ultrasound during 2nd trimester echocardiography. J Matern Fetal Neonatal Med. 2016;29(14):2223 8.
Martínez González LR. Valor del estudio por ultrasonido del timo fetal Rev Cubana Genét Comunitaria. 2012;6 (3):5 9.
Paladini D. How to identify the thymus in the fetus: the thy box. Ultrasound Obstet Gynecol. 2011 Apr. Apr.;37(4):488 92.
Muñoz Chápuli M, Gámez F, Bravo C, Ortiz L, Pérez R, De León Luis JA. The Thy Box for Sonographic Assessment of the Fetal Thymus: Nomogram and Review of the Literature. J Ultrasound Med. 2015 May;34(5):853 8.
Wiechec M, Knafel A, Nocun A. Prenatal detec tion of congenital heart defects at the 11 to 13 week scan using a simple color Doppler protocol including the 4 chamber and 3 vessel and trachea views. J Ultrasound Med. 2015;34(4):585 94.
Sze Lai CW, Tung Chau AK, Peng Lee C. Comparing the accuracy of obstetric sonography and fetal echocardiography during pediatric cardiology consultation on the prenatal diagnosis of congenital heart disease. J Obstet Gynaecol Res. 2016 Feb.;42(2):166 71.
Vigneswaran TV , Homfray T , Allan LD , Simpson JM , Zidere V . Persistently elevated nuchal translucency and the fetal heart. J Matern Fetal Neonatal Med. 2018 Sep.;31(18):2376 80.
Hidalgo Fadic Y. Alteraciones funcionales del timo en el modelo murino NZBWF1 de lupus eritematoso sistémico [tesis]. Chile: Repositorio ANID; 2018.
Patel A, Costello JM, Backer CL, Pasquali SK, Hill KD, Wallace AS, et al. Prevalence of Noncardiac and Genetic Abnormalities in Neonates Undergoing Cardiac Operations : Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg. 2016 Jun. 17;102(5):1607 14.
Sierra Santos, L, Casaseca García P, García Moreno A, Martín Gutiérrez V. Síndrome de Di George. Rev Clín Med Familia. mayo ago. 2014; 7(2):141 3
Karl K, Heling KS, Sarut L ó pez A, Thiel G, Chaoui R. Thymic thoracic ratio in fetuses with trisomy 21, 18 or 13. Ultrasound Obstet Gynecol. 2012 Oct.; 40(4):412 7.
Bogarapu S, Pinto NM, Etheridge SP, Sheng X, Liesemer KN, Young PC, et al . Screening for Congenital Heart Disease in Infants with Down Syndrome : Is Universal Echocardiography Necessary ? Pediatr Cardiol. 2016 Jun. 9;37(7):1222 7.
Bergström S, Carr H , Petersson G, Stephansson O, Bonamy AK, Dahlström A, et al . Trends in Congenital Heart Defects in Infants With Down Syndrome. Pediatrics. 2016 Jun. 1;138(1):pii: e20160123.
Moreira Filho CA, Bando SY, Bernardi Bertonha F, Nascimento Silva F, Da Fontoura Costa L, Rodrigues Ferreira L. Modular transcriptional repertoire and MicroRNA target analyses characterize genomic dysregulation in the thymus of Down syndrome infants. Oncot arget. 2016 Feb. 16;7(7): 7497 533.
Sciaky Tamir Y, Hershkovitz R, Mazor M, Shelef I, Erez O. The use of imaging technology in the assessment of the fetal inflammatory response syndrome imaging of the fetal thymus. Prenat Diagn. 2015 May;35(5):413 9.
Zhao X, Huang Z, Liu X, Chen Y, Gong W, Yu K, et al . The switch role of the Tmod4 in the regulation of balanced development between myogenesis and adipogenesis. Gene. 2013 Sep. 11;532(2):263 71.
L inder GE, Chuntova PD, McLelland BT, Añó L, Obodo UC, Crider NJ, et al . Semaphorin 4A is dynamically regulated during thymocyte development in mice. Cell Immunol . 2013 Apr. 12;281( 2):150 8.
Caissutti C, Familiari A, Khalil A, Flacco ME, Manzoli L, Scambia G, et al . Small fetal thymus and adverse obstetrical outcome: a systematic review and a meta analysis. Acta Obstet Gynecol Scand. 2017 Dec. 6;97(2):111 21.
Ekin A, Gezer C, Taner CE, Sol maz U, Gezer NS, Ozeren M. Prognostic value of fetal thymus size in intrauterine growth restriction. J Ultrasound Med. 2016 Feb. 9;35(3):511 7.
Brandt JS, Bastek JA, Wang E, Purisch S, Schwartz N. Second Trimester Sonographic Thymus Measurements Are Not Associated With Preterm Birth and Other Adverse Obstetric Outcomes. J Ultrasound Med. 2016 Apr. 12;35(5):989 97.
Maymon E , Romero R , Bhatti G , Chaemsaithong P , G ó mez L ó pez N , Panaitescu B , et al . Chronic inflammatory lesions of the placenta are associated with an up regulation of amniotic fluid CXCR3: A marker of allograft rejection. J Perinat Med. 2018 Feb. 23;46(2):123 37.
Borgelt JM , Möllers M , Falkenberg MK , Amler S , Klockenbusch W , Schmitz R . Assessment of first trimester thymus size and correlation with maternal diseases and fetal outcome. Acta Obste t Gynecol Scand. 2 016 Nov. 17;95(2):210 6.