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OBSTETRICS | GYNECOLOGY
| FERTILITY |
COUNSELING SERVICES
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Advanced ultrasound screening of nuchal
translucency
provides earlier detection of fetal
abnormalities
mmSince the
1980’s, pregnant women have been offered second-trimester
testing for Down syndrome and other common genetic defects.
This has involved doing testing at about 15-16 weeks of
pregnancy to measure levels of Alpha-Fetoprotein (AFP) and other
substances in the mother's blood.
mmMore
recently, first-trimester screening for Down syndrome and other
chromosomal abnormalities has been developed. Between 11 and 14
weeks, an ultrasound examination is done to measure the
thickness of an area at the back of the fetal neck (nuchal
translucency, or NT), combined with measuring levels of two
substances in the mother’s blood (free beta subunit of
human chorionic gonadotropin, or HCG, and pregnancy-associated plasma protein-A, or PAPP-A).
Results are available in 6-7 days. Like the AFP testing,
this is a screening test: the results indicate that the woman
is at increased risk, and a definitive diagnostic test
(amniocentesis or CVS) is used to determine if the fetus is
affected.
mmThe
ultrasound procedure used to measure NT requires special
training, skills, and ongoing quality assurance, and we are
very pleased that our sonographers are now trained and
certified to do NT scans.
mmFirst-trimester
testing, when results are negative, can provide earlier
reassurance to concerned parents than second-trimester
screening. If results are positive, definitive testing
can be done to either allow patients to have more time to
prepare for a child with health problems, or to have a safer
and more private procedure if a pregnancy termination is
elected.
mmFirst-trimester
testing is estimated to identify 91% of fetuses with Down
syndrome. It can also identify 40% of fetal heart defects, 97%
of cases of Trisomy 18, and some other birth defects. It
is not however useful as a screening test for Spina Bifida,
which can usually be detected by a combination of measuring AFP
at 15+ weeks and an ultrasound at 18-20 weeks. We offer
all our patients an 18-20 week ultrasound for examination of
fetal anatomy.
mmFurther information on first-trimester screening is available by searching the website of the American College of Obstetricians and Gynecologists. |
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