Abstract
The aim of this study was to determine the outcome of chromosomally normal livebirths with increased fetal nuchal translucency at 10-14 weeks' gestation. Clinical follow up of 89 chromosomally normal livebirths that in fetal life had a minimum nuchal translucency thickness of 3.5 mm and a comparison group of 302 infants whose fetal nuchal translucency thickness at 10-14 weeks of gestation was less than 3.5 mm was performed. Major abnormalities, mainly structural defects of the cardiovascular or skeletal systems, were found in 10.1% (nine of 89) of the group with increased translucency, compared to 2% (five of 302) in those with translucency of less than 3.5 mm (chi2=11.9, p<0.001). Delay in achievement of developmental milestones was observed in one of the infants with increased translucency and in one of the comparison group. The findings of this study show that in chromosomally normal fetuses increased nuchal translucency thickness at 10-14 weeks of gestation is a marker for fetal abnormalities including structural defects and genetic syndromes.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Benacerraf B. R., Greene M. F., Holmes L. B. The prenatal sonographic features of Noonan's syndrome. J Ultrasound Med. 1989 Feb;8(2):59–63. doi: 10.7863/jum.1989.8.2.59. [DOI] [PubMed] [Google Scholar]
- Cha'ban F. K., Van Splunder P., Los F. J., Wladimiroff J. W. Fetal outcome in nuchal translucency with emphasis on normal fetal karyotype. Prenat Diagn. 1996 Jun;16(6):537–541. doi: 10.1002/(SICI)1097-0223(199606)16:6<537::AID-PD911>3.0.CO;2-4. [DOI] [PubMed] [Google Scholar]
- Chervenak F. A., Isaacson G., Blakemore K. J., Breg W. R., Hobbins J. C., Berkowitz R. L., Tortora M., Mayden K., Mahoney M. J. Fetal cystic hygroma. Cause and natural history. N Engl J Med. 1983 Oct 6;309(14):822–825. doi: 10.1056/NEJM198310063091403. [DOI] [PubMed] [Google Scholar]
- Cullen M. T., Gabrielli S., Green J. J., Rizzo N., Mahoney M. J., Salafia C., Bovicelli L., Hobbins J. C. Diagnosis and significance of cystic hygroma in the first trimester. Prenat Diagn. 1990 Oct;10(10):643–651. doi: 10.1002/pd.1970101004. [DOI] [PubMed] [Google Scholar]
- Hewitt B. Nuchal translucency in the first trimester. Aust N Z J Obstet Gynaecol. 1993 Nov;33(4):389–391. doi: 10.1111/j.1479-828x.1993.tb02117.x. [DOI] [PubMed] [Google Scholar]
- Hyett J., Moscoso G., Papapanagiotou G., Perdu M., Nicolaides K. H. Abnormalities of the heart and great arteries in chromosomally normal fetuses with increased nuchal translucency thickness at 11-13 weeks of gestation. Ultrasound Obstet Gynecol. 1996 Apr;7(4):245–250. doi: 10.1046/j.1469-0705.1996.07040245.x. [DOI] [PubMed] [Google Scholar]
- Johnson M. P., Johnson A., Holzgreve W., Isada N. B., Wapner R. J., Treadwell M. C., Heeger S., Evans M. I. First-trimester simple hygroma: cause and outcome. Am J Obstet Gynecol. 1993 Jan;168(1 Pt 1):156–161. doi: 10.1016/s0002-9378(12)90906-0. [DOI] [PubMed] [Google Scholar]
- Langer J. C., Fitzgerald P. G., Desa D., Filly R. A., Golbus M. S., Adzick N. S., Harrison M. R. Cervical cystic hygroma in the fetus: clinical spectrum and outcome. J Pediatr Surg. 1990 Jan;25(1):58–62. doi: 10.1016/s0022-3468(05)80164-2. [DOI] [PubMed] [Google Scholar]
- Nadel A., Bromley B., Benacerraf B. R. Nuchal thickening or cystic hygromas in first- and early second-trimester fetuses: prognosis and outcome. Obstet Gynecol. 1993 Jul;82(1):43–48. [PubMed] [Google Scholar]
- Nicolaides K. H., Azar G., Byrne D., Mansur C., Marks K. Fetal nuchal translucency: ultrasound screening for chromosomal defects in first trimester of pregnancy. BMJ. 1992 Apr 4;304(6831):867–869. doi: 10.1136/bmj.304.6831.867. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nicolaides K. H., Azar G., Snijders R. J., Gosden C. M. Fetal nuchal oedema: associated malformations and chromosomal defects. Fetal Diagn Ther. 1992;7(2):123–131. doi: 10.1159/000263659. [DOI] [PubMed] [Google Scholar]
- Pandya P. P., Kondylios A., Hilbert L., Snijders R. J., Nicolaides K. H. Chromosomal defects and outcome in 1015 fetuses with increased nuchal translucency. Ultrasound Obstet Gynecol. 1995 Jan;5(1):15–19. doi: 10.1046/j.1469-0705.1995.05010015.x. [DOI] [PubMed] [Google Scholar]
- Savoldelli G., Binkert F., Achermann J., Schmid W. Ultrasound screening for chromosomal anomalies in the first trimester of pregnancy. Prenat Diagn. 1993 Jun;13(6):513–518. doi: 10.1002/pd.1970130613. [DOI] [PubMed] [Google Scholar]
- Schulte-Vallentin M., Schindler H. Non-echogenic nuchal oedema as a marker in trisomy 21 screening. Lancet. 1992 Apr 25;339(8800):1053–1053. doi: 10.1016/0140-6736(92)90574-m. [DOI] [PubMed] [Google Scholar]
- Shulman L. P., Emerson D. S., Felker R. E., Phillips O. P., Simpson J. L., Elias S. High frequency of cytogenetic abnormalities in fetuses with cystic hygroma diagnosed in the first trimester. Obstet Gynecol. 1992 Jul;80(1):80–82. [PubMed] [Google Scholar]
- Shulman L. P., Emerson D. S., Grevengood C., Felker R. E., Gross S. J., Phillips O. P., Elias S. Clinical course and outcome of fetuses with isolated cystic nuchal lesions and normal karyotypes detected in the first trimester. Am J Obstet Gynecol. 1994 Nov;171(5):1278–1281. doi: 10.1016/0002-9378(94)90147-3. [DOI] [PubMed] [Google Scholar]
- Trauffer P. M., Anderson C. E., Johnson A., Heeger S., Morgan P., Wapner R. J. The natural history of euploid pregnancies with first-trimester cystic hygromas. Am J Obstet Gynecol. 1994 May;170(5 Pt 1):1279–1284. doi: 10.1016/s0002-9378(94)70142-3. [DOI] [PubMed] [Google Scholar]
- Ville Y., Lalondrelle C., Doumerc S., Daffos F., Frydman R., Oury J. F., Dumez Y. First-trimester diagnosis of nuchal anomalies: significance and fetal outcome. Ultrasound Obstet Gynecol. 1992 Sep 1;2(5):314–316. doi: 10.1046/j.1469-0705.1992.02050314.x. [DOI] [PubMed] [Google Scholar]
- Wilson R. D., Venir N., Farquharson D. F. Fetal nuchal fluid--physiological or pathological?--In pregnancies less than 17 menstrual weeks. Prenat Diagn. 1992 Sep;12(9):755–763. doi: 10.1002/pd.1970120908. [DOI] [PubMed] [Google Scholar]
- Witt D. R., Hoyme H. E., Zonana J., Manchester D. K., Fryns J. P., Stevenson J. G., Curry C. J., Hall J. G. Lymphedema in Noonan syndrome: clues to pathogenesis and prenatal diagnosis and review of the literature. Am J Med Genet. 1987 Aug;27(4):841–856. doi: 10.1002/ajmg.1320270412. [DOI] [PubMed] [Google Scholar]
- van Zalen-Sprock M. M., van Vugt J. M., van Geijn H. P. Non-echogenic nuchal oedema as a marker in trisomy 21 screening. Lancet. 1992 Jun 13;339(8807):1480–1481. doi: 10.1016/0140-6736(92)92074-p. [DOI] [PubMed] [Google Scholar]