Nuchal Translucency (NT)

Dr. Panagiotis Polyzos MD PhD MSc

Obstetrician Gynaecologist
Doctor of Medicine, University of Athens Medical School

Panagiotis Polyzos, Gynaecologist Obstetrician, is active at the Institute of Life - IVF Unit of Iaso Maternity Hospital.

Contents

Αυχενική διαφάνεια – υπερηχογραφικός έλεγχος 1ου τριμήνου

Nuchal Translucency (NT)

Who is the Nuchal Translucency Scan recommended for?

The nuchal translucency scan is recommended for all pregnant women, as it is the primary prenatal screening test in the 1stο trimester of pregnancy.

As maternal age increases, so does the likelihood of the baby being born with one of the most common chromosomal abnormalities, such as Trisomy 21 (Down syndrome). If the final calculated risk for a chromosomal abnormality is high, and after counseling the couple, more specialized tests may be performed, such as chorionic villus sampling or amniocentesis.

Among other things, the nuchal translucency scan can:

  • Determine the number of fetuses. In case of a multiple pregnancy, it establishes whether each fetus has a separate or a shared placenta (chorionicity).
  • Determine the gestational age, the estimated due date, and the risk of preterm birth.
  • Determine the risk of preeclampsia and intrauterine growth restriction of the fetus.
  • Assess the development of the most important fetal organs and individual fetal systems.

Is there any risk during the Nuchal Translucency Scan?

The nuchal translucency ultrasound is a painless examination and carries no risk for the pregnant woman or the baby. It is usually performed transabdominally, and in certain cases, a transvaginal approach may be required.

What can the Nuchal Translucency Scan Diagnose?

The nuchal translucency scan detects:

  • The risk of one of the most common chromosomal abnormalities, such as Down syndrome (Trisomy 21), Edwards syndrome (Trisomy 18), and Patau syndrome (Trisomy 13).
  • Anatomical abnormalities, such as those affecting the heart, brain, spine, abdominal wall, kidneys, and urinary bladder.
  • Skeletal dysplasias.
  • The risk of preeclampsia and intrauterine growth restriction (IUGR) (assessed by evaluating blood flow in the uterine arteries).
  • The risk of preterm birth (assessed by measuring cervical length).

 

For the estimation of the risk of chromosomal abnormalities, four ultrasound markers are evaluated::

  • Measurement of nuchal translucency thickness
  • Assessment of the presence of the nasal bone
  • Evaluation of blood flow across the fetal heart tricuspid valve
  • Evaluation of blood flow in the ductus venosus, a small vessel in the fetal liver

At a later stage (usually the next day), the final risk calculation is completed. This includes a combination of the ultrasound findings and biochemical markers — hormones present in the mother’s blood (PAPPA, free b-hCG , which form the PlGF).

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How should I prepare for the Ultrasound?

Before your scheduled appointment, think about any questions you may have regarding the ultrasound or your pregnancy and write them down so you can discuss them with your doctor or midwife during your visit.

A good breakfast, a light snack, and/or juice are ideally recommended before your appointment. At the same time, it is advised to drink enough water so that the bladder fills, allowing for better visualization of the uterus and cervix.

Upon your arrival at the clinic, you will be asked to complete the required medical history form, as well as provide any tests you have already undergone for evaluation of the results. For your own convenience, it is helpful to organize these tests in a folder by date and type of examination.

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What do the Nuchal Translucency results show?

It is important to understand that this examination is a screening test and not a diagnostic method. Its sensitivity reaches 95%, with approximately 3% false-positive results. The screening assesses for Trisomy 21 (Down syndrome) as well as Trisomy 18 (Edwards syndrome) and Trisomy 13 (Patau syndrome).

The results of the ultrasound and biochemical tests will indicate a low risk for the above syndromes (i.e., a probability lower than 1:300) in most women.

In every case, you will receive full information regarding the significance of this risk and the various options for possible further testing, such as invasive testing (chorionic villus sampling — amniocentesis) or non-invasive testing (cell-free DNA test).