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Nuchal Transluency

To be certain your NT scan is performed correctly, it is important that you have your scan performed at an accredited practice. A NT computer package was developed by the London Fetal Medicine Foundation in the 1990s and was based on more than 100.000 pregnancies.

There is strict auditing of the NT ultrasound work performed by every accredited practice in the world. This ensures that the NT scan test is being performed correctly. Recently, the Royal Australian College of Obstetricians and Gynaecologists has taken over regular auditing of Australian practices.

Paradise Ultrasound has passed its audit since opening. The Director, Anna Galea was the first Sonographer to bring the Fetal Medicine Nuchal Translucency program to the Gold Coast and Tweed areas.

Anna has been committed to keeping Paradise Ultrasound Sonographer’s up to date and accredited. Paradise Ultrasound offer Nuchal Translucency risks inclusive of Nasal Bone, Ductus Venous, Intracranial Translucency (spina bifida risk), Pre-Eclampsia Screening and Growth Restriction.

The nuchal translucency (NT) scan, or ‘12-week scan,’ is an ultrasound performed in the first trimester between 11.5 weeks and 13 weeks, six days. However is best performed at 12 weeks. This scan is combined with a blood test that looks at two specific hormones of pregnancy: the free-Beta hCG and PAPP-A (pregnancy associated plasma protein A). Your doctor will supply a referral to one of the pathology clinics for this. It should be done atleast 3-5 working day prior to the NT appointment. or anytime over 10 weeks gestation.

This combined test is a very accurate non-invasive screening test available to help identify a fetus at risk for Down syndrome as well as other chromosomal abnormalities and some major structural abnormalities. An ultrasound screening test is non-invasive and does not have any side effects or complications.

However, it will not give a yes/no answer to whether a problem such as Down syndrome is present. The only way to diagnose Down syndrome or other chromosomal abnormalities is by having a invasive diagnostic test — either a CVS or an Amniocentesis — and testing the fetal cells. These tests are invasive and require a needle to be passed into the maternal abdomen and uterus and therefore carry a small risk of miscarriage.

Many patients do not wish to have the diagnostic test because of the small risk of miscarriage and prefer to have the ultrasound screening test, the NT scan, to help them decide if they wish to proceed to testing the fetus.

Unfortunately, while NT combined with the first trimester biochemical blood test is a very accurate screening test available for chromosomal and structural abnormalities, it will not detect all fetuses affected with Down syndrome or other chromosomal abnormalities. It is approximately 95% accurate when combining the NT, nasal bone, ductus venosus and blood test together.

Advantages of the 12 week NT scan

  • There are several advantages to undergoing a 12-week NT scan, including:
  • Estimates individual risk for Down syndrome and other      chromosomal abnormality
  • Screen for Spina Bifida
  • More accurately date the pregnancy
  • Diagnose multiple fetuses
  • Diagnose early pregnancy failure
  • Allow early detection of some major structural abnormalities
  • Estimate individual risk for Pre-Eclampsia and growth restricted fetus
  • NT and Down syndrome

Chromosomal abnormalities occur when there is a change in the number or structure of the chromosomes. Normally we have 46 chromosomes, 23 pairs numbered 1-22 and a pair of sex chromosomes.
Boys have XY and girls have XX. The most common chromosomal abnormality seen at birth is Down syndrome. In Down syndrome, an extra copy of chromosome 21 is present, giving a total of 47 chromosomes.

When there is extra fluid and the NT measurement is thicker than normal, there is an association with chromosomal anomalies such as Down syndrome and some structural abnormalities in the fetus. Not all babies with an increased NT measurement have Down syndrome or any structural abnormality.

The baby is measured from head to bottom to determine the crown-rump length and the nuchal translucency is measured. Nasal bone and ductus venosus are obtained. These measurements are entered into the computer program with the patient’s date of birth and the first trimester biochemistry blood test. The computer then calculates the patient’s age-related risk for Down syndrome and the new individual risk for this pregnancy.

At Paradise Ultrasound the findings are then discussed with the patient on the day if the blood test results are available. The combined NT result will provide the patient with a risk assessment. This will either be a high risk (risk is greater than 1 in 300) or a low risk (risk less than 1 in 300). As this is a screening test and not a diagnostic test, even with a low calculated risk, Down syndrome is not completely excluded and can still occur occasionally.

Paradise Ultrasound is pleased to be the first diagnostic imaging group to offer risk assessment for pre-eclampsia on the Gold Coast.

This is performed at the time of the 12 week’s fetal anatomy/ Downs syndrome risk assessment ultrasound, as such, there is no additional cost for pre-eclampsia screening.

Pre-eclampsia is a relatively common complication. It is an illness you can get only during pregnancy (any time after 20 weeks of pregnancy) or up to six weeks after birth. It can affect you and your unborn baby. If it is predicted in time, it can be monitored and treated.

Pre-eclampsia can affect any pregnancy. You are more at risk if:
1. This is your first pregnancy
2. You, your mother or sister had pre-eclampsia
3. You have a BMI (Body mass index) of 35 or more
4. Your age is 49 or over
5. You are expecting twins, triplets or quads
6. You have a medical problem such as high blood pressure, kidney problems and /or diabetes
7. Your pregnancy was medically assisted e.g. IVF

The exact cause of pre-eclampsia is not known, but it is recognised that problems in the placenta are involved. In pre-eclampsia the placenta cannot get as much blood from you as it needs. This affects you and your baby in different ways. In some case women who become effected by pre-eclampsia will be admitted to hospital and in many cases their babies will need to be delivered prematurely.
Preventive care of pre-eclampsia high risk cases aims to prevent or delay the development of pre-eclampsia.

The pregnancy can then safely continue and the baby will have time to develop.
A simple treatment of low doses of aspirin, under the direct care of your doctor, has being proven to be effective. For such treatments to work, they must be initiated before 16 weeks of pregnancy.

When you have a pre-eclampsia screening, the risk factors are combined with your test results so that in most cases the increase risk of pre-eclampsia can be ruled out, giving you peace of mind during your pregnancy. In the event the results return high risk, your doctor will be able to initiate your treatment at the optimum time and monitor your pregnancy more carefully.

3D/4D is included as complimentary in all Obstetric scans at no additional charge. 

For more information or to make an appointment, please give us a call on 07 55392 555.

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