4.6 Article

Outcome of pregnancy in chromosomally normal fetuses with increased nuchal translucency in the first trimester

Journal

ULTRASOUND IN OBSTETRICS & GYNECOLOGY
Volume 18, Issue 1, Pages 9-17

Publisher

WILEY
DOI: 10.1046/j.1469-0705.2001.00454.x

Keywords

10-14-week scan; cardiac defects; fetal abnormalities; first trimester; genetic syndromes; nuchal translucency

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Objectives To study the outcome of chromosomally normal pregnancies with increased nucbal translucency at the 10-14-week scary. Design Retrospective stud), of 1320 chromosomally normal singleton pregnancies with nuchal translucency of greater than or equal to3.5 mm. In addition to fetal karyotyping these patients were managed with follow-up scans at 14-16 and 20-22 weeks, specialist fetal echocardiography and in selected cases by infection. screening and further genetic testing. Results In the 1320 pregnancies there were 68 (5.15%) spontaneous abortions or intrauterine deaths, 18 (1.36%) neonatal and infant deaths and 154 (11.67%) terminations of pregnancy. In the 1080 (81.82%) survivors, 60 (5.56%) had abnormalities requiring medical or surgical treatment or leading to mental handicap. The chance of a livebirth with, no defects in the group with nuchal translucency of 3.5-4.4 mm was 86%, for those with translucency of 4.5-5.4 mm it was 77%, for those with translucency of 5.5-6.4 mm it was 67%, and for those with translucency of greater than or equal to 6.5 mm it was 31 %. Conclusions Increased fetal nuchal translucency, is associated with chromosomal abnormalities, many, fetal defects and genetic syndromes. In the majority of cases a series of antenatal investigations, including fetal karyotyping, detailed scans, fetal echocardiography, as well as genetic testing and infection screening, that cart be completed by 20 weeks of gestation would distinguish between the pregnancies destined to result in adverse outcome and those leading to the delivery of infants without major defects.

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