Is there a nuchal translucency millimeter measurement above which there is no added benefit from first trimester serum screening?

Christine H. Comstock, Fergal D. Malone, Robert H. Ball, David A. Nyberg, George Saade, Richard L. Berkowitz, Jose Ferreira, Lorraine Dugoff, Sabrina D. Craigo, Ilan E. Timor-Tritsch, Stephen R. Carr, Honor M. Wolfe, Diana W. Bianchi, Mary E. D'Alton

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Objective: The purpose of this study was to evaluate whether there is a nuchal translucency (NT) measurement, independent of gestational age, above which immediate diagnostic testing should be offered without waiting for first trimester serum markers. Study design: Thirty-six thousand one hundred twenty patients had successful measurement of simple NT at 10 3/7 to 13 6/7 weeks and had first trimester serum screening. No risks were reported until second trimester serum screening was completed. Results: Thirty-two patients (0.09%) had NT ≥4.0 mm; the lowest combined first trimester trisomy 21 risk assessment in euploid cases was 1 in 8 and among aneuploidy cases was 7 in 8. One hundred twenty-eight patients (0.3%) had simple NT ≥3.0 mm: the lowest combined first trimester trisomy 21 risk assessment of any patient in this group was 1 in 1479 and the lowest risk assessment among aneuploid cases was 1 in 2. Ten patients (8%) had first trimester trisomy 21 risk assessments lowered to less that 1:200 and none of these 10 cases had an abnormal outcome. Conclusion: During first trimester Down syndrome screening, whenever an NT measurement of 3.0 mm or greater is obtained there is minimal benefit in waiting for serum screening results, and no benefit for NT of 4.0 mm or greater. Differentiation between cystic hygroma and enlarged simple NT (≥3.0 mm) is now a moot point as both are sufficiently high risk situations to warrant immediate CVS.

Original languageEnglish (US)
Pages (from-to)843-847
Number of pages5
JournalAmerican Journal of Obstetrics and Gynecology
Volume195
Issue number3
DOIs
StatePublished - Sep 2006

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Nuchal Translucency Measurement
First Pregnancy Trimester
Down Syndrome
Serum
Aneuploidy
Cystic Lymphangioma
Second Pregnancy Trimester
Gestational Age
Biomarkers

Keywords

  • Aneuploidy risk
  • Down syndrome screening
  • First trimester screening
  • Nuchal translucency

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Is there a nuchal translucency millimeter measurement above which there is no added benefit from first trimester serum screening? / Comstock, Christine H.; Malone, Fergal D.; Ball, Robert H.; Nyberg, David A.; Saade, George; Berkowitz, Richard L.; Ferreira, Jose; Dugoff, Lorraine; Craigo, Sabrina D.; Timor-Tritsch, Ilan E.; Carr, Stephen R.; Wolfe, Honor M.; Bianchi, Diana W.; D'Alton, Mary E.

In: American Journal of Obstetrics and Gynecology, Vol. 195, No. 3, 09.2006, p. 843-847.

Research output: Contribution to journalArticle

Comstock, CH, Malone, FD, Ball, RH, Nyberg, DA, Saade, G, Berkowitz, RL, Ferreira, J, Dugoff, L, Craigo, SD, Timor-Tritsch, IE, Carr, SR, Wolfe, HM, Bianchi, DW & D'Alton, ME 2006, 'Is there a nuchal translucency millimeter measurement above which there is no added benefit from first trimester serum screening?', American Journal of Obstetrics and Gynecology, vol. 195, no. 3, pp. 843-847. https://doi.org/10.1016/j.ajog.2006.06.006
Comstock, Christine H. ; Malone, Fergal D. ; Ball, Robert H. ; Nyberg, David A. ; Saade, George ; Berkowitz, Richard L. ; Ferreira, Jose ; Dugoff, Lorraine ; Craigo, Sabrina D. ; Timor-Tritsch, Ilan E. ; Carr, Stephen R. ; Wolfe, Honor M. ; Bianchi, Diana W. ; D'Alton, Mary E. / Is there a nuchal translucency millimeter measurement above which there is no added benefit from first trimester serum screening?. In: American Journal of Obstetrics and Gynecology. 2006 ; Vol. 195, No. 3. pp. 843-847.
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abstract = "Objective: The purpose of this study was to evaluate whether there is a nuchal translucency (NT) measurement, independent of gestational age, above which immediate diagnostic testing should be offered without waiting for first trimester serum markers. Study design: Thirty-six thousand one hundred twenty patients had successful measurement of simple NT at 10 3/7 to 13 6/7 weeks and had first trimester serum screening. No risks were reported until second trimester serum screening was completed. Results: Thirty-two patients (0.09{\%}) had NT ≥4.0 mm; the lowest combined first trimester trisomy 21 risk assessment in euploid cases was 1 in 8 and among aneuploidy cases was 7 in 8. One hundred twenty-eight patients (0.3{\%}) had simple NT ≥3.0 mm: the lowest combined first trimester trisomy 21 risk assessment of any patient in this group was 1 in 1479 and the lowest risk assessment among aneuploid cases was 1 in 2. Ten patients (8{\%}) had first trimester trisomy 21 risk assessments lowered to less that 1:200 and none of these 10 cases had an abnormal outcome. Conclusion: During first trimester Down syndrome screening, whenever an NT measurement of 3.0 mm or greater is obtained there is minimal benefit in waiting for serum screening results, and no benefit for NT of 4.0 mm or greater. Differentiation between cystic hygroma and enlarged simple NT (≥3.0 mm) is now a moot point as both are sufficiently high risk situations to warrant immediate CVS.",
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AU - Comstock, Christine H.

AU - Malone, Fergal D.

AU - Ball, Robert H.

AU - Nyberg, David A.

AU - Saade, George

AU - Berkowitz, Richard L.

AU - Ferreira, Jose

AU - Dugoff, Lorraine

AU - Craigo, Sabrina D.

AU - Timor-Tritsch, Ilan E.

AU - Carr, Stephen R.

AU - Wolfe, Honor M.

AU - Bianchi, Diana W.

AU - D'Alton, Mary E.

PY - 2006/9

Y1 - 2006/9

N2 - Objective: The purpose of this study was to evaluate whether there is a nuchal translucency (NT) measurement, independent of gestational age, above which immediate diagnostic testing should be offered without waiting for first trimester serum markers. Study design: Thirty-six thousand one hundred twenty patients had successful measurement of simple NT at 10 3/7 to 13 6/7 weeks and had first trimester serum screening. No risks were reported until second trimester serum screening was completed. Results: Thirty-two patients (0.09%) had NT ≥4.0 mm; the lowest combined first trimester trisomy 21 risk assessment in euploid cases was 1 in 8 and among aneuploidy cases was 7 in 8. One hundred twenty-eight patients (0.3%) had simple NT ≥3.0 mm: the lowest combined first trimester trisomy 21 risk assessment of any patient in this group was 1 in 1479 and the lowest risk assessment among aneuploid cases was 1 in 2. Ten patients (8%) had first trimester trisomy 21 risk assessments lowered to less that 1:200 and none of these 10 cases had an abnormal outcome. Conclusion: During first trimester Down syndrome screening, whenever an NT measurement of 3.0 mm or greater is obtained there is minimal benefit in waiting for serum screening results, and no benefit for NT of 4.0 mm or greater. Differentiation between cystic hygroma and enlarged simple NT (≥3.0 mm) is now a moot point as both are sufficiently high risk situations to warrant immediate CVS.

AB - Objective: The purpose of this study was to evaluate whether there is a nuchal translucency (NT) measurement, independent of gestational age, above which immediate diagnostic testing should be offered without waiting for first trimester serum markers. Study design: Thirty-six thousand one hundred twenty patients had successful measurement of simple NT at 10 3/7 to 13 6/7 weeks and had first trimester serum screening. No risks were reported until second trimester serum screening was completed. Results: Thirty-two patients (0.09%) had NT ≥4.0 mm; the lowest combined first trimester trisomy 21 risk assessment in euploid cases was 1 in 8 and among aneuploidy cases was 7 in 8. One hundred twenty-eight patients (0.3%) had simple NT ≥3.0 mm: the lowest combined first trimester trisomy 21 risk assessment of any patient in this group was 1 in 1479 and the lowest risk assessment among aneuploid cases was 1 in 2. Ten patients (8%) had first trimester trisomy 21 risk assessments lowered to less that 1:200 and none of these 10 cases had an abnormal outcome. Conclusion: During first trimester Down syndrome screening, whenever an NT measurement of 3.0 mm or greater is obtained there is minimal benefit in waiting for serum screening results, and no benefit for NT of 4.0 mm or greater. Differentiation between cystic hygroma and enlarged simple NT (≥3.0 mm) is now a moot point as both are sufficiently high risk situations to warrant immediate CVS.

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