Why does four-dimensional color Doppler ultrasound show that the fetus has no nasal bone? Four-dimensional color Doppler ultrasound is an examination made by pregnant women at 20-24 weeks of pregnancy. At this time, the fetus is still small and immature. If the fetal limbs are blocked or the fetal position is low, it is normal for the doctor not to see the fetal nose clearly.
In this case, pregnant women need to check the color Doppler ultrasound regularly to see if the fetal nasal bone is well developed.
No matter how low the fetal nasal bone is, there is still a nasal bone. If it is really missing, then the fetus may be accompanied by malformations of other organs, so it is necessary to have regular checkups during pregnancy.
What does Tang NT mean by low risk? Down's screening and NT screening are both tests to exclude children with Down's syndrome. If the NT value is less than 3 mm, it means that the fetus is normal and the risk of Down's screening is low, which means that it has passed.
The obvious characteristics of children with Down's syndrome are short nose, inconsistent eyes and hands, big head, facial deformity and mental retardation. However, a short nose does not mean that there is no nasal bone.
Doctors with four-dimensional fetus found no nasal bones. Pregnant women can do non-invasive DNA or amniocentesis according to the doctor's requirements to completely rule out fetal Down syndrome and chromosomal abnormalities. The doctor will give advice to pregnant women according to the test results.
The subject was pregnant for 23 weeks and 2 days, and four-dimensional B-ultrasound showed no nasal bone. What concept? Does the baby have no nose or a flat nose? Actually, it's not. Four-dimensional ultrasound showed that the fetus had no nasal bone, suggesting that the probability of fetal chromosome abnormality increased, especially in 2 1- trisomy. The study suggests that the probability of losing nasal bone in 2 1- trisomy is close to 50%, but some normal fetuses also have B-ultrasound to suggest that the fetus has no nasal bone.
Speaking of this, in fact, everyone should know that the nasal bone is actually a soft indicator of chromosomal abnormalities. The absence of nasal bone suggests that the probability of fetal chromosome abnormality is increased, especially 2 1- trisomy, but the Down's screening of subjects suggests low risk, and NT also suggests that there is no low risk and high risk in the normal range. Now the main task is to eliminate fetal chromosomal abnormalities, especially 2 1- trisomy, so in this case, we can choose non-invasive DNA examination or amniocentesis karyotype analysis. My personal opinion is that we can do it. After all, amniocentesis belongs to prenatal diagnosis.
As for whether the child should stay, it actually depends on whether the non-invasive DNA is low-risk, or whether there is nothing unusual in the amniocentesis. Then the child can stay. If there is a high risk of non-invasive DNA, amniocentesis is needed. Amniocentesis indicates abnormality, which is often 2 1- trisomy, and some of them are 18- trisomy, so there is no doubt that it cannot be retained, and it is necessary to induce labor to terminate pregnancy.
To sum up, at 23 weeks and 2 days of pregnancy, four-dimensional B-ultrasound showed that there was no nasal bone, the risk of Down's screening was low, and the NT value was in the normal range, so we mainly looked at the results of non-invasive DNA examination and amniocentesis. If there is nothing unusual, you can check in. If it is confirmed to be 2 1- trisomy, 18- trisomy or other chromosomal abnormalities, it is not allowed to stay, and it is recommended to induce labor. Good luck with your pregnancy.
Four-dimensional massive ovulation is one of the most comprehensive examination items of fetal malformation during pregnancy. If the four-dimensional large-scale ovulation has passed, the pregnant mother can breathe a sigh of relief in the next pregnancy. However, if something happens to the baby, before this problem is solved, the pregnant mother seems to be tied with a heavy stone, which makes the pregnant mother breathless and depressed to the extreme.
(Image from the Internet)
Twenty-three weeks pregnant, two-dimensional shows no nasal bone, so the risk of doing Tang screening nt is low. Can the child stay? For a normal baby, they have two nasal bones. After birth, the two nasal bones will gradually fuse together, and the baby's nasal bones usually begin to develop in the sixth week of pregnancy. By the 10 week of pregnancy, the baby's facial bones began to ossify, so when doing NT examination, the baby can already see the nasal bones. If the baby's nasal bones are not clear after four-dimensional color ultrasound.
(Image from the Internet)
So, does it mean that if you find that your baby doesn't have a nasal bone, it means that your baby can't have it?
Of course not.
In medicine, nasal bone loss is actually only a "soft indicator" of ultrasound, that is to say, the baby with nasal bone loss may or may not have problems. Generally speaking, the baby's nasal bone should be fully developed after 12 weeks. If there is no nasal bone, pregnant mothers need to be cautious. Some babies without nasal bones have other problems.
23 weeks pregnant, no nasal bones. Although the results of Down's screening and NT of pregnant mothers are normal, the accuracy of Down's screening is not high, only about 60%. Pregnant mothers need to go to more advanced hospitals for more accurate further examination, such as umbilical cord blood examination or amniocentesis, with higher accuracy.
In short, the baby doesn't have a nasal bone, which may be a machine problem or an angle problem, but it may also mean that the baby has chromosomal abnormalities, so we must first rule out whether the baby has chromosomal abnormalities. As for the baby's future appearance, the lack of nasal bone will not affect the baby's growth and appearance. At most, the nose is a little flat, and pregnancy can continue.
If it is a simple loss of nasal bone and there is no other abnormality, I think it can be left.
What if the judgment is simple nasal bone loss?
First of all, the structure of the fetus
Four-dimensional examination will examine other tissues and structures of the fetus, such as heart, brain structure, long bones of limbs, eyeballs, stomach bubbles, gallbladder and spine. Four-dimensional examination can screen most fetal malformations. This can determine whether the fetus is complicated with other structural abnormalities.
Second, chromosome examination
Because only Tang screening NT was done, according to the early Tang screening with the highest accuracy, the accuracy rate was 85%, and only the risk of Down syndrome was checked. Nasal bone loss is common in 2 1-3 body syndrome, but other chromosomal diseases cannot be ruled out. In order to rule out chromosomal abnormalities, I suggest amniocentesis.
Amniocentesis is a classic method to diagnose fetal chromosomal diseases, and it is also the gold standard for diagnosis at present. In other words, the accuracy rate is very high, up to 99%. Amniocentesis can not only detect Down syndrome and 18 trisomy, but also detect the abnormal number and large segment structure of all other chromosomes. Therefore, it is necessary to use sheep puncture to rule out chromosomal abnormalities.
What about simple nasal bone loss? If it is a simple nasal bone loss, there is no other fetal abnormality. Such a baby can have it completely. Babies without nasal bones only have some differences in appearance, that is, they look particularly flat nose. But other than that, the baby is completely healthy. Simple nasal bone loss can be repaired by some plastic surgery. Nowadays, plastic surgery technology is so developed that it is very simple to pad a nose.
What should I do if the nasal bone is missing and the structure and chromosome are abnormal? If the fetus is not only missing the nasal bone, but also complicated with fetal structure and chromosome abnormalities, I think it is unlikely that such a baby can have it in most cases. In this case, it is recommended to go to a higher hospital for prenatal consultation immediately.
Combined with their own situation, and then analyze whether the baby with missing nasal bone can have it. After I have done it, I also want to say that a baby who simply lacks a nasal bone is also an angel sent by heaven. Please be kind to him.
T: Twenty-three weeks of pregnancy +2 four-dimensional showed no nasal bone. The risk of doing Tang sieve NT is low. Can the child stay?
During prenatal examination, pregnant mothers are most worried about the baby's health, especially what they have missed. What does it mean that there is no nasal bone in the four dimensions? Can you still have children?
No nasal bone = deformity? As we all know, most babies with Down syndrome have facial hypoplasia, but this does not mean that all children with facial hypoplasia are Down's children.
In other words, even a normal fetus has a certain probability of losing the nasal bone.
Therefore, the absence of nasal bone is not the only criterion to judge whether the fetus is healthy and normal.
What about the lack of nasal bone? Check the chromosome, because the subjects have passed NT and Tang screening with low risk, but it has been 23 weeks now, so they can only do amniocentesis or umbilical cord puncture for karyotype analysis to rule out chromosomal abnormalities.
Under normal circumstances, the fetal nasal bone is fully developed in about 13 weeks. If it is found that the nasal bone is still undeveloped after 13 weeks, villus detection or amniocentesis should be performed as soon as possible, and the diagnosis should be ruled out as soon as possible.
Of course, the diagnosis can only be made after 23 weeks of sheep puncture. If the chromosome is normal, then the absence of nasal bone will have no effect on the fetus. On the other hand, if the chromosome is abnormal, then it is not recommended that the fetus stay.
Thank you for your invitation. I'm Shen Huan, a reproductive doctor. I'm glad to answer this question for you.
If the ultrasound shows no nasal bones, Further prenatal diagnosis is needed. Detection of fetal chromosomal abnormalities by amniocentesis or umbilical cord blood puncture. Moreover, ultrasound should be used to check whether there are other malformations and whether they are fatal.
In view of this problem, today, according to the questions I often ask in clinical pregnant mothers, I will popularize four-dimensional color Doppler ultrasound for everyone.
1. Is it necessary to do four-dimensional color ultrasound? First of all, the main function of four-dimensional color Doppler ultrasound is not to eliminate abnormalities, and it is not a necessary item for routine fetal examination.
The main function of four-dimensional color Doppler ultrasound is to see the dynamic three-dimensional fetus, which plays an important role in the diagnosis of facial features and limb dysplasia, but it cannot replace large-scale abnormal examination.
It is also mentioned in "China Fetal Prenatal Ultrasound Examination Standard" that there is no need for three-dimensional or four-dimensional ultrasound in routine fetal ultrasound examination at this stage.
Here, Dr. Lin suggested that four-dimensional ultrasound is definitely not necessary, but when two-dimensional ultrasound suggests that there are inaccurate deformities that need further examination, it is recommended to do four-dimensional color Doppler ultrasound for further examination.
Second, I have done four-dimensional color Doppler ultrasound, is it not necessary to do B-ultrasound screening? This idea is definitely wrong. Four-dimensional color Doppler ultrasound is only an ultrasonic detection technology, which cannot replace the real formal medical examination.
3. Does four-dimensional color Doppler ultrasound have radiation? Four-dimensional color Doppler ultrasound, like ordinary color Doppler ultrasound, works on the basis of ultrasonic transmission imaging, so it can be clearly said that there is no radiation and almost no harm to the baby, so pregnant mothers don't have to worry too much.
4. When is the best examination time for four-dimensional color Doppler ultrasound? Dr. Lin suggested that 20-28 weeks of pregnancy is the best time to do four-dimensional color Doppler ultrasound examination, because the 24-week fetus is the key period for the rapid development of the brain. At this time, most organs of the fetus have developed and the amniotic fluid volume is moderate.
In addition, the fetus has entered the abdominal cavity, which is more conducive to the screening of fetal malformation.
At this time, the activity space of the fetus in the mother's stomach is good, and the intrauterine shooting effect is good.
5. Is the four-dimensional color Doppler ultrasound color? Many pregnant mothers think that four-dimensional color Doppler ultrasound is color, but it is not. Four-dimensional color ultrasound is as yellow as three-dimensional color ultrasound.
Six, four-dimensional color ultrasound can see birthmarks? When I was in the clinic, I met many pregnant mothers and asked, doctor, can you see if the fetus has a birthmark by doing a four-dimensional color Doppler ultrasound?
Because many pregnant mothers are worried that their babies have birthmarks, after all, birthmarks have a great influence on the baby's face value.
Dr. Lin is here to tell you for sure that it can't be seen according to the current level of ultrasonic imaging technology and equipment conditions.
7. Do you still need to do Down's screening after four-dimensional color Doppler ultrasound? Of course not. Down's screening is a necessary item for large area teratoma, which can't be replaced by four-dimensional color Doppler ultrasound.
Down's screening is to comprehensively judge the risk of Down's syndrome by detecting the serum of pregnant mothers and combining with clinical symptoms, while ultrasonic images (four-dimensional color Doppler ultrasound) are used to screen the developmental malformations of fetal organs such as face, limbs and internal organs.
They are different inspection items. Therefore, pregnant mothers should not be careless and check one of them.
Honey, I understand how you feel. Every step of pregnancy, expectant mothers and fathers can be said to be walking on thin ice. A little trouble will make a family have sex, which is really not easy. It's only 23 weeks now, and the baby is still young. Don't panic! I post a video below, I hope it will be useful to you.
Twenty-three weeks of pregnancy +2 four-dimensional shows no nasal bone, and the risk of doing Tang screening NT is low. Can the child stay?
In fact, this is a very uncomfortable thing. No matter who you are, you don't want to encounter this situation, but if you encounter it, you can't escape. You must find a way to solve the problem positively. Only in this way can you be responsible for the fetus.
What if the four-dimensional examination shows that the fetus has no nasal bone? Not long ago, a pregnant woman came to the hospital for examination. At first, she just said that she wanted to see the development of the fetus in four dimensions, and she didn't explain the rest. The doctor found that one side of the fetal nasal bone was missing and asked the pregnant woman if she had checked it before. Is there anything abnormal in the fetus? At this time, the pregnant mother told the truth, saying that she had checked before and the child's nasal bone was gone. I want to see if you can tell. Are you sure what the situation is?
This is actually a very sad thing, but there is absolutely no need to take an examination of a doctor. Since there was a problem with the previous examination, it is actually no problem to find more hospitals and see more doctors. It is entirely based on the review of the fetal situation, and there is no need to hide it. In fact, it is even worse for the fetus. Instead, we should face it directly, and the most important thing is to study solutions.
Do Tang Can Sie and NT have low-risk children? However, it is not enough to just make Tang sieve and NT. If you want to know if there is a chromosome problem, you still need to do amniocentesis to make a diagnosis. Sheep puncture is the gold standard for clinical diagnosis of chromosome diseases. If there is no problem with sheep puncture, don't be too nervous, but if there is a problem with sheep puncture, you should seriously consider it. After all, it is related to the future of the fetus.
In short, pregnant mothers can't not go to the hospital for examination because they are afraid of problems. This is not right, and the exam items that should be done are also indispensable. If you evaluate your thoughts for the sake of examination, you are not only irresponsible for yourself, but also irresponsible for the fetus. Finally, I wish all pregnant mothers and babies good health! Do a non-invasive dna test