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The performance of an intermediate 16th‐week ultrasound scan for the follow‐up of euploid fetuses with increased nuchal translucency
Author(s) -
Le Lous Maela,
Bouhanna Philippe,
Colmant Claire,
Rozenberg Patrick,
Quibel Thibaud
Publication year - 2016
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4756
Subject(s) - medicine , fetus , ultrasound , gestation , pregnancy , obstetrics , prenatal diagnosis , products of conception , diaphragmatic hernia , gestational age , gynecology , radiology , hernia , genetics , biology
Objective The objective of the study is to assess the utility of an intermediate ultrasound scan at 16 +0 to 18 +6 weeks of gestation in euploid fetuses with increased nuchal translucency ≥ 3.5 mm. Methods Three hundred eighty‐nine fetuses with nuchal translucency (NT) ≥ 3.5 mm were identified in two prenatal centers between January 2008 and December 2012. Pregnancy work‐up included karyotyping, monthly detailed ultrasound scan starting with a 16th‐week scan, a cardioechography, and a genetic counseling. Abnormal findings and pregnancy outcomes were analyzed 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 16 of the major defects (31.3%), and the 16th‐week scan was useful to identify an additional 21 of them (41.2%), whereas the 22nd‐week 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), genitourinary ( 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 close to 100% after 20 weeks, irrespective of initial NT. Conclusion The intermediate ultrasound was useful in fetuses with increased NT pregnancy work‐up. © 2015 John Wiley & Sons, Ltd.