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What Does The Nuchal Translucency Scan Report Indicate?

Posted on Wed, 14 Oct 2015

Question: Hi,

My wife is pregnant and she is currently 14 weeks and 6 days.( LMP : 9-June)
We had taken NT scan on 10-Sep ( 13 weeks and 2 days) which measured 1.4 mm of Nuchal translucency.
Dual marker test was taken on 12-Sep and the results are given below.

-----------------AS IN REPORT-------------------

Screening profile : First Trimester Screening, Software used : ROCHE SsdwLab 5.

Gaussian markers:
Level of Free bhCG 78.25 mlU/ml at 12-Sep 2.27 MoM
Level of PAPPA-A 8771.9 mlU/l at 12-Sep 1.24 MoM
Level of NT 1.4 mm ( CRL of 77 mm): 0.74 MoM ( Truncated to 0.78 MoM in trisomy 21 Risk calculations).
(Truncated to 0.78 MoM in trisomy 18-13 Risk Calculations).
Marker values have been corrected by, weight (55 kg), asian

Down's Syndrome Risk ; 1: 1455 calucalted as Risk at screening date. Low Risk.
The maternal age related risk for Down's syndrome is 1:342

Edward's and Patau's syndrome Risk ; Less than 1:100000 calcualted as Risk at screening date.
Low Risk

Please note that the gestationl age by USG exceeds 13 weeks 6 days ( 14 weeks 1 day)

-----------------END OF REPORT-------------------

As I have read that dual marker has to be taken before 13 weeks and 6 days and the last line of the report says differently , just wanted to know if this is fine.

Please advise if everything is normal

Thanks
Ramanathan U

Answered by Dr. Deepti Verma (43 minutes later)

Brief Answer:
Please upload the earlier ultrasound reports

Detailed Answer:
Hi dear, I have gone through your question and understand your concerns.Dual marker should be done before 13 weeks 6 days of gestation, as values of markers beyond this gestation do not give the true risk assessment.
Your wife was 13 weeks 4 days (by her last menstrual period ) on the day she gave the sample for dual marker. however the report mentions the gestational age calculated by the ultrasound and that is 14 weeks 1 day on that day.
Please attach the earlier ultrasound reports so that I can review them and give you detailed explanation.
Hope you found the answer helpful. Please do get back to me with the ultrasound reports, if feasible.
Wishing you both good health.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Deepti Verma (48 hours later)

Thank you Doctor.
Attached the scan report and dual marker test report.

Please advise.

Regards,
Ramanathan U

Answered by Dr. Deepti Verma (4 hours later)

Brief Answer:
Quadruple marker at 16 weeks

Detailed Answer:
Hi dear, thanks for responding.
The gestational age calculated by ultrasound on day of sampling for dual marker was 14 weeks 1 day.
In this scenario, the dual marker is not sensitive in detecting the risk for chromosomal anomalies.
I will suggest you to get her "Quadruple marker" done at 16 weeks of pregnancy.
It is a serum screening, similar to dual test, done at 16-18 weeks to determine the risk of chromosomal anomalies.
Hope you found the answer helpful. Please do get back to me for further queries.
Wishing you both good health.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (15 hours later)

Thank you Doctor.

As per LMP , as on 12-Sep ( the day blood sample provided for dual marker) it comes to 13 weeks and 4 days.
We were thinking the age calculation from ultrasound scan will be less than or equal to the days calculated using LMP.

But we are seeing age calculated by ultrasound is 14 weeks and 1 day whereas the actual days as per LMP comes to 13 weeks and 4 days ( as on 12-Sep)

Could you please clarify on the days calculation.

Regards,
Ramanathan U

Answered by Dr. Deepti Verma (26 minutes later)

Brief Answer:
Detailed explanation

Detailed Answer:
Hi dear, I will try to clarify the situation.
Actually, in dual marker, it is recommended to calculate the age as per the ultrasound done.
Ultrasound calculates the gestational age by the crown rump length( CRL) of the fetus, by a software which is feeded in the ultrasound machine. It depends upon the ultrasonologist that how accurately the CRL was measured.
The gestation age by her LMP was definitely 13 weeks4 days on 12 th September. But dual marker considers the age calculated by the ultrasound.
Hope you found the answer helpful.
Please do get back for further queries.
Regards
Dr Deepti Verma

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar