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お医者さん
お医者さん

胎児におこるむくみで悩む妊婦さんにお伝えしたい3つのこと

医者

胎児のむくみが日本で注目されるようになったのは、21世紀になってからです。検査技術が発達した現代は、お母さんのおなかの中にいる胎児の状態を確認することができるようになりました。

胎児のむくみはエコーなどで発覚しやすく、産婦人科で報告されることがあります。胎児のむくみは全く問題ない場合から、先天的な異常を知らせるものまで様々です。胎児にむくみがあると告知された場合、どのような可能性を考えるべきか、正しい知識をもって考慮する必要があります。ただむやみに怖がるのではなく、冷静に情報を分析してみましょう。

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胎児むくみが異常と判断とされる理由とは

赤ちゃん

産婦人科で指摘される胎児のむくみとは、首の後ろの部分をエコーで確認したもので、NT(Nucal Translucency)と呼ばれるものです。日本語で胎児頚部浮腫といわれています。この場所はリンパの流れる場所であり、11週~13週頃の胎児には首にむくみがあるように見えます。

胎児の首のむくみが問題とされるのは、ダウン症の赤ちゃんの約75%に同様のむくみがあったことから指摘されるようになりました。胎児にむくみがあっても、そのすべてが問題となるわけではありません。ただし、そのむくみの厚みによって異常な状態であると判断するようです。

胎児にむくみが出る場合、染色体の異常の可能性を示唆することになりますが、この可能性とは、一般的な母体と比べてという意味のようです。つまり、「異常になる可能性が高い」というものではなく「確率として異常になる場合がある」というものです。

そのため、胎児の首にむくみがあるからといって、それが必ず異常であると判断できるものではないということを覚えておきましょう。

染色体異常に関しては、羊水検査か絨毛検査で確定されるものです。検査によって確定されるまでは、他の胎児と確率は同じです。不安によってストレスがかかると、母体だけでなく胎児にも影響するため、検査結果が出るまでは出来るだけ穏やかに過ごしてください。

胎児の首のむくみが染色体異常と判断される数値について

胎児の首のむくみを産婦人科で指摘される場合、一般的に3mm~3.5mm以上が異常だと判断されます。

胎児のむくみ(NT)が3mmの場合、染色体異常によるダウン症(21トリソミー)の発生率はおよそ3倍になるとされています。これは他の母体と比べた場合です。4mmで18倍、5mmで28倍、6mm以上となると36倍になります。

同時に、3mmの胎児むくみがある100人に対して、3~4人には染色体異常があり、残りの93人は全くの正常だというデータもあります。つまり、93%は正常であるということです。非常にむくみが厚いとされる6mm以上の場合、約50%に染色体異常があり、30%は正常というデータがあるようです。

このデータを見る限りでも、胎児の首のむくみだけで、必ず異常であるというわけではないことがわかります。ただし、染色体が正常であっても、心臓奇形などの異常がある胎児でもむくみが出ることがあり、その指標としても使われています。

胎児のむくみをチェックするのは、10週以降に行われるのが定例です。むくみがある場合、羊水検査などを行うことを勧められることになります。ただし、羊水検査などは流産の引き金にもなりやすく、単純な検査ではありません。将来を考え必要だとする場合は、染色体異常を確認するための検査を希望しましょう。

羊水検査等で染色体が正常だとされた場合でも、安定期に入り、より詳しく異常がないかチェックする必要があります。産婦人科への定期的な診察はもとより、信頼でき、継続して通える病院を選びましょう。

必ずセカンドオピニオンを持ちましょう

胎児のむくみを判断できるようになるのは、11週~13週頃といわれています。つまり、これ以前に病院でむくみを指摘されたり、染色体異常について報告された場合、正しい診断ではない可能性があります。全身浮腫などの大きな異常がある場合は、早期に指摘されることもありますが、胎児が成長している過程であり、簡単に判断されるべきものではありません。

実際に、胎児のむくみを指摘しただけで、染色体異常を避けるための中絶について情報を与える病院もあるようです。そのような病院では、羊水検査などの確定検査についても不安が残ります。特に不安が残る場合は、胎児ドッグなどを扱っている専門医に相談することをお勧めします。また、一つの病院の診断にこだわるのではなく、セカンドオピニオンとして大学病院や総合病院などでの受診も行ってみましょう。

まとめ

妊娠は神秘のものであり、母体の中で成長する胎児はまさに奇跡のようなものです。現代の科学技術の発展によって胎児の状態が確認できるようになったことで、より安全に出産できるようになりました。同時に、母体にとっては不安を促す要素も目に見えてしまいます。胎児のむくみを報告された場合、必ず家族と相談し、セカンドオピニオンなど十分な情報の上で将来のことを考えましょう。元気な赤ちゃんが生まれることを心から祈っています。

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Check Also

足のむくみをマッサージ

足の疲れとむくみの解消に効果的!簡単、速効性のある足枕

立ち仕事の方は、足のむくみに悩 …

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