The performance of an intermediate 16th week ultrasound scan for the follow up of euploid fetuses with increased nuchal translucency

Abstract

Objective

To assess the utility of an intermediate ultrasound scan at 16⁺⁰ -18⁺⁶ weeks of gestation (WG) in euploid fetuses with increased nuchal translucency ≥ 3.5 mm.

Methods

389 fetuses with NT ≥ 3.5 mm were identified in two prenatal centers between January 2008 and December 2012. Pregnancy work-up included karyotyping, monthly detailed US scan starting with a 16 weeks scan, a cardioechography, and a genetic counseling. Abnormal findings and pregnancy outcomes were analysed retrospectively.

Results

Of the 389 fetuses included, 52% had normal karyotype. Among euploid fetuses, 51 (30.7%) structural defects were identified overall. First trimester scan was useful to identify sixteen of the major defects (31.3%), the 16th week scan an additional 21 of them (41.2%) whereas the 22nd week scan pregnancy scan discovered an additional 14 (27.4%). Structural defects discovered with the 16th week scan were cardiac defects (n = 7), polymalformative syndromes (n = 3), left diaphragmatic hernias (n = 3) limbs abnormalities (n = 2), genito-urinary (n = 2), microretrognathism (n = 2), hydrops (n = 1) and exomphalos (n = 1). If the intermediate scan was normal, the chances of a favorable outcome were as high as 85% and were closed to 100% after 20 weeks, irrespective of initial NT.

Conclusion

The intermediate ultrasound was useful in fetuses with increased NT pregnancy work-up.

from #Medicine via ola Kala on Inoreader http://ift.tt/1Z3uv5H
via IFTTT