Abnormal nuchal findings on screening ultrasonography: aneuploidy stratification on the basis of ultrasonographic anomaly and gestational age at detection

Am J Obstet Gynecol. 1996 Oct;175(4 Pt 1):995-9. doi: 10.1016/s0002-9378(96)80040-8.

Abstract

Objective: Our purpose was to determine the specific likelihood of different aneuploidies by gestational age in patients with nuchal folds and simple and septated nuchal membranes.

Study design: Retrospective database analysis was performed of 158 consecutive patients with a nuchal fold or simple or septated nuchal membrane on either abdominal or vaginal ultrasonography.

Results: Thirty-eight patients with nuchal folds, 65 with simple nuchal membranes, and 55 with septated nuchal membranes were evaluated. Septated nuchal membranes were associated with the highest incidence of karyotypic abnormalities (> 50%). A peak incidence of trisomy 21 (27%) was found in the early midtrimester, leveling off to 11% by the late midtrimester. The late first trimester had a high incidence of trisomy 18 (22%), occurring more frequently than 45,X.

Conclusion: Ultrasonographic anomalies in the posterior neck are associated with aneuploidy from 21% to 58% of the patients in this selected population. Each anomaly has different risks for aneuploidy type, varying with gestational age at diagnosis.

MeSH terms

  • Aneuploidy*
  • Chromosome Aberrations / epidemiology
  • Chromosome Disorders
  • Chromosomes, Human, Pair 18
  • Congenital Abnormalities / diagnostic imaging
  • Congenital Abnormalities / genetics
  • Down Syndrome
  • Female
  • Gestational Age
  • Humans
  • Incidence
  • Karyotyping
  • Neck / abnormalities*
  • Neck / diagnostic imaging*
  • Neck / embryology
  • Pregnancy
  • Retrospective Studies
  • Trisomy
  • Ultrasonography, Prenatal*