Abnormal Nuchal Translucency Scan

[jessy143]

Hi everyone ,



I'm new here ...I'm in my 14th week now and had my Nuchal translucency scan done in the 13th week..I'm 27 yrs old and offered to have the Nuchal translucency scan done on my own..though My doc never recommended that...

i went thru the Nuchal translucency scan without any worries and the results have me worried..since the doc told me its abnormal with nuchal fold thickness of 3.3 mm which is beyond the safe limits..he said anything betn 1 mm to 2mm is the normal limit..and i had MSAFP (blood work) done the same day and the results came in 3 days with the same abnormal result...I asked the doc for my hormonal values and it turned out to be HCG = 0.39 MoM and PAPPA = 0.99 MoM...But blood work is dependent on Nuchal translucency scan and i have no hopes to rely on this test either..The Doc called me the next day and offered me Amniocentesis ..but me and my spouse are not going to take the risk of an infection or a miscarriage...Also my baby heart beat rate was 164 beats per minute at 13.3 weeks and the baby was too fast and uncoperative that the technicain had a tough time measuring the fold thickness.So i was guessing some human error which calculating the thickness of the fold...She just banged my belly a couple of times..since my baby was very uncoperative..

After the Nuchal translucency scan and blood work results my score rose from 1/1100 to 1/230 of having a DS baby ...My doc ruled out trisomy 18 and is concerned about Down syndrome..

We are quite assured that our baby is normal and don't talk about it much at home..But i thought it would be great if i could have people around who could give me the nuchal fold thickness and could make a comparison myself...I will have another Nuchal translucency scan at 18-22 weeks in which the fold thickness should not be greater than 6 mm...So just praying that everything works out fine and i have a healthy baby by feb 24th 2007...
Hoping to hear from u all..

[angelfish]

Hi Jessy, sorry I know nothing about these tests, but I'm sure someone here will be able to give you some info. Just wanted to send (hugs) and supportive vibes, as it sounds like all this is very worrying for you.

[visitor2]

Hi Jessy,

I'm so sorry to hear you are going though this.
I just had a amnio last Thursday and i was so scared of having it done and after all i did was rest for a few days i did noting other than go to to the toilet and change the telly over with the remote. It took me over two weeks to make my mind up to have it done we did say no at first but the worry of not knowing stood in the way. I'm now waiting for my results and should get them next week.
My risk of Trimosy 21 was 1:294 and the NF was 1:4 which was good but it was the blood work that changed it all.

I hope everything works out well for you.
If you need to talk please feel free to email me.

[storm]

mm jess I'm no help either, mine was 2.9mm . bubby moving around alot does make it hard for the u/s to get a good measurment, that's what happened to me, Hope all is well, I'm sure it will be!!

[rails]

Hi Jessy,
my results were the nuchal translucency measurement was stated to be on the upper range of normal @ 2.3mm
the risk of trisomy 21 at 1:326
We decided to have an amnio at 16 weeks (same with Michelle could not stand the not knowing), with complete rest for the next 2 days , i got my results for DS the next day with the FISH test (had to wait 2wks for full results)

My results came back normal

i am scared to get pg again because i don't want to got thru this again...is a very stressful time ... hugs to you with what you decide to do xxx

[MrsBump]

Hi Jess,
I had my NT scan and it was within the normal range. Sorry about the vaugeness but i dont know the exact measurement. I hope for your sake that it was a mis calculation as baby was moving around so much!
Oh and we are due 2 days apart. Im due on the 22nd!
Feel free to meet up in the belly buddies forum. 15th-28th feb! Hope to see you there!
Jen

[Kar]

Hi Jess
I'm due on 19th feb, and had my NT about 10 days ago. I had a measurement of 2.2 and a combined probability of down's of 1 in 475.

Here's something that I read on a UK website:

What is nuchal translucency?

This is a collection of fluid under the skin at the back of a baby's neck at 10-14 weeks that can be measured using ultrasound. All babies have some fluid, but in many babies with Down's syndrome, the nuchal translucency (NT) is increased.

An NT scan is a method of assessing whether your baby is likely to have Down's syndrome. It's a screening test. A screening test can only estimate the risk of your baby having Down's, as opposed to a diagnostic test, such as CVS or amniocentesis, which will give you a definite diagnosis (but also carries a small risk of miscarriage).

The NT scan can't tell for certain whether your baby is affected. However, it can help you decide whether or not to have a diagnostic test.


When can I have the test?

NT scans are usually performed from 11 to 13 weeks + 6 days of pregnancy. Before 11 weeks the scan is technically difficult because the baby is so tiny and, after 14 weeks, excess fluid may be absorbed by the baby's developing lymphatic system.

What is a normal measurement?

An NT measurement of up to 2.0mm is normal at about 11 weeks, and up to about 2.8mm by 13 weeks and 6 days. This is because the NT normally grows in proportion to the growth of the baby. A baby with a normal NT of 1.3mm will be low risk.

If the NT is increased, it does not mean there is definitely a problem. Some normal babies have increased fluid, too. A baby with an NT of 2.9mm, which is at the upper limit of the normal range, will have a higher risk, but nine out of 10 babies with a measurement between 2.5mm and 3.5mm will be completely normal.

As the NT increases, so does the risk. A baby with an NT of 6mm and will be very high risk for Down's, as well as other chromosomal and genetic syndromes and heart problems. Fortunately, not many babies have as much fluid as this.

Sounds to me like, you have (a) been given some fairly inaccurate stats, 1-2mm is the range for 11wk pregs not 13 weeks, (b) you are not likely to be able to have another NT scan as the Nucchal fold dissappears at 14wks. (c) the risk of miscarriage is 1 in 200 and your risk is less than that. This means that the risk of the amnio is higher than doing nothing. And they should also have counselled you that unless you definitely are willing to consider terminating your pregnancy as a result of a negative amnio - don't have one. (d) had a technician who had a lot of trouble getting a measurement. The reliability of the test is entirely reliant on the accuracy of the technician. Banging your belly seems completely out of order. My technician worked with us for nearly 90mins to get our baby in the right place - all done very gently and professionally!

Good for you for sticking to your guns. If you feel your baby is fine then that's the best indicator. This is a horrible thing that has happened to you - I hope that the girls here can ease your worry a bit.

And why not come join us in the Bellybuddies for 15-28th Feb. We'd love to have you in there.

[jessy143]

Hey KAR....

That was a lot of info...which i never managed to find in the internet...Moreover Guys from Uk seem to know a lot of stats and info ...

U have really given a lot of info..It was highly reassuring as well as informative.....
Infact the technicain who did the initial baby measurement was highly professional ...
But the next lady who did the nuchal fold measurement seemed to be a little impatient and poked me a couple of times with the probe...It s not exactly banging...but poking with a lot of pressure and she ofcourse apologised to me...

Since my insurance was not in the network....my insurance refused to pay for NT scan and so we dropped the NT scan ....Then the receptionist called me and asked my insurance phone number so she could find out some way to make them pay for the scan...I dont know what they talked ...but my insurance company agreed it seems...So i guess these guys want to make some money too...The Doc said....See since ur nuchal fold thickess is too big...u r in the high risk category....so its better u do the amnio...

I will definitly do the 15-22 week scan but not definitly amnio...lets hope things get better and i'm definitly not going to that scan centre again..I'm looking out for a different reputable scan near my area....

Thank u so much guys for all the valuable info...I'm leaving to canada today...will be back in a week...Hope to discuss a lot on this and gather as much info as possible...

And Michelle asked me about the quad scan....Its a very reliable scan done in 15-22 week if i'm not wrong...My doc said if it showed positive ...then definitly we have to have the amnio...In quad screen,The blood sample is sent to a laboratory and tested for the presence of the following four substances that are normally found in the baby's blood, brain, spinal fluid and amniotic fluid:

Alpha-fetoprotein (AFP) -- a protein produced by the fetus' liver
Unconjugated Estriol (UE) -- a protein produced in the placenta and in the fetus' liver
Human Chorionic Gonadotrophin (hCG) -- a hormone produced by the placenta
Inhibin-A -- a hormone produced by the placenta

I have a slight doubt if MSAFP, triple and quad screen are the same...since i read it in the internet....

Thank u guys...

[jessy143]

Hi guys,

Talked to my Doc...seems i have to do amniocentesis...

[visitor2]

Jessy goodluck with the amniocentesis. Will be thinking of you.

How long do you have to wait for your results ?

[jessy143]

Hi,

i will have my 2nd U/S done in the next 2 weeks and the doc wants to look out for markers for DS..then probably we have to decide abt the amnio..

[*Jessica*]

jessy143 I find your story very interesting and similar to mine so far, but I was given completely different advice....

NT measured between .27mm and .31mm

Blood results were as follows:
free beta-hCG .98MOM
pregnancy-associated plasma protein A .66MOM

(Note I was told by the genetic counsellour that babies with Trisomy 21 can have higher beta-hCG of 1.0 and lower plasma protein A of 1.0).

We went to see a genetic counsellor today who told us that our combined risk of 1:465 was in the average range and considering an amnio has 1:200 risk of miscarriage, well, the maths is obvious...

Throught this whole pregnancy I have been surprised (to say the very least) at the conflicting words of GP's, conficting tests, etc etc etc...

Please ask to see a gentic counsellor first, she really helped us....

I hope that can help you in some way... I am really glad to see you are having a 2nd u/s first.

[lovemybubs]

hiya

Just thought id add my experience:

I didnt have the NT scan and bloods, but at my 19w scan the nuchal translucency measurement was 7.6, so very abnormal. My baby didnt have Downs.

[Renaee]

Jessy143 - I just wanted to add that if you really don't think you could terminate the pregnancy no matter what they tell you, then don't go ahead with the amnio. Also, wanted to mention a great article written on diagnostic testing by GP and Ob Dr Sarah j Buckley (she has a book, called gentle birth, genter mothering, but article may also be on her website sarahjbuckley.com.au)

A friend of mine had good TS measurements but bloodwork of 1:300. She agonised over whether to do the test, then went ahead with it - but she was so stressed and anxious, I was concerned that this was worse for her and her baby's health than anything. Turned out to be a negative result, so all was well. But it really makes you wonder is it worth going through all of this - in our mothers day there was no such technology available, so you just accepted what life gave you.

All the very best - I hope you can update us soon with some good news.

[visitor2]

Jessy how are you doing ?