scholarly journals Clinical Utility of Increased Nuchal Translucency at 11-13 weeks of Gestation in Twin Pregnancies based on the Chorionicity

2020 ◽  
Author(s):  
Siwon Lee ◽  
Hyun-Mi Lee ◽  
You Jung Han ◽  
Moon Young Kim ◽  
Hye Yeon Boo ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Odds Ratio ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Adverse Pregnancy ◽  
Twin Pregnancies ◽  
First Trimester Ultrasound ◽  
Fetal Karyotype ◽  
Increased Nuchal Translucency ◽  
Structural Anomalies

Objectives: To assess clinical implications of increased nuchal translucency (INT) in twin pregnancies based on the chorionicity. Methods: This was a retrospective review of the twin pregnancies who underwent first trimester ultrasound with nuchal translucency (NT) measurement at 11-13 weeks of gestation from January 2006 to December 2014. Data were collected using the OB database and the chart review. Pregnancy outcomes including gestational weeks at the delivery, abnormal fetal karyotypes, fetal structural anomalies, twin specific complications were analyzed. Results: A total of 1,622 twin pregnancies with INT≥95th percentile in one or both fetuses were identified. In all twin pregnancies with INT, abnormal fetal karyotypes were identified in 17 (8.6%) patients (odds ratio=13.28, CI=5.990-29.447, P=0.000) and twin-specific complications were identified in 23 (11.6%) patients (odds ratio=2.398, CI=1.463-3.928, P=0.001) compared to those with normal NT. Among the INT group, when the groups were subdivided into monochorionic (MC) and dichorionic (DC) pregnancies, 14.8% and 29.6% of the MC pregnancies had structural anomalies in one or both fetuses (odds ratio=5.774, 95% CI=1.445-23.071, P=0.01) and twin-specific complications (odds ratio=4.379, 95% CI=1.641-11.684, P=0.03), respectively, compared to DC pregnancies. The prevalence of abnormal fetal karyotypes was not statistically different in patients with INT when compared between MC and DC pregnancies (P=0.329). Conclusions: INT was associated with a higher rate of twin-specific complications and fetal structural anomalies in MC twin pregnancies rather than abnormal fetal karyotype. Therefore, NT measurement in MC twin pregnancies can be a useful tool for prediction of adverse pregnancy outcomes. Appropriate counseling and surveillance based on the chorionicity is imperative in prenatal care of twin pregnancies.

scholarly journals Clinical Utility of Increased Nuchal Translucency at 11–13 Weeks of Gestation in Twin Pregnancies Based on the Chorionicity

2021 ◽  
Vol 10 (3) ◽  
pp. 433
Author(s):  
SiWon Lee ◽  
Hyun-Mi Lee ◽  
You Jung Han ◽  
Moon Young Kim ◽  
Hye Yeon Boo ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Odds Ratio ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Adverse Pregnancy ◽  
Twin Pregnancies ◽  
First Trimester Ultrasound ◽  
Fetal Karyotype ◽  
Increased Nuchal Translucency ◽  
Structural Anomalies

To assess clinical implications of increased nuchal translucency (INT) in twin pregnancies based on the chorionicity. This was a retrospective review of the twin pregnancies who underwent first trimester ultrasound with nuchal translucency (NT) measurement at 11–13 weeks of gestation from January 2006 to December 2014. Data were collected using the OB database and the chart review. Pregnancy outcomes, including gestational weeks at the delivery, abnormal fetal karyotypes, fetal structural anomalies, and twin-specific complications, were analyzed. A total of 1622 twin pregnancies with INT ≥ 95th percentile in one or both fetuses were identified. In all twin pregnancies with INT, abnormal fetal karyotypes were identified in 17 (8.6%) patients (odds ratio = 13.28, CI = 5.990–29.447, p = 0.000) and twin-specific complications were identified in 23 (11.6%) patients (odds ratio = 2.398, CI = 1.463–3.928, p = 0.001) compared to those with normal NT. Among the INT group, when the groups were subdivided into monochorionic (MC) and dichorionic (DC) pregnancies, 14.8% and 29.6% of the MC pregnancies had structural anomalies in one or both fetuses (odds ratio = 5.774, 95% CI = 1.445–23.071, p = 0.01) and twin-specific complications (odds ratio = 4.379, 95% CI = 1.641–11.684, p = 0.03), respectively, compared to DC pregnancies with 2.9% for structural anomalies and 8.8% for twin-specific complications. The prevalence of abnormal fetal karyotypes was not statistically different in patients with INT when compared between MC and DC pregnancies (p = 0.329). INT was associated with a higher rate of twin-specific complications and fetal structural anomalies in MC twin pregnancies rather than abnormal fetal karyotype. Therefore, NT measurement in MC twin pregnancies can be a useful tool for predicting adverse pregnancy outcomes. Appropriate counseling and surveillance based on the chorionicity are imperative in the prenatal care of twin pregnancies.

scholarly journals INCREASED NUCHAL TRANSLUCENCY IN A FETUS WITH A NORMAL KARYOTYPE: CASE REPORT

2019 ◽  
Vol 2 (1) ◽  
pp. 59-61
Author(s):  
Cristina Moisei ◽  
Anca Lesnica ◽  
Romina Marina Sima ◽  
Liana Pleș
Keyword(s):  
Chorionic Villus ◽  
Normal Karyotype ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Trisomy 18 ◽  
Trisomy 13 ◽  
Chorionic Villus Sampling ◽  
Increased Risk ◽  
First Trimester Ultrasound ◽  
Increased Nuchal Translucency

Nuchal translucency (NT) is the normal fluid filled subcutaneous space measured at the back of the fetal neck measured in the late first trimester and early second trimester. Nuchal translucency screening can detect approximately 80% of fetuses with Down syndrome and other major aneuploidies with a rate of 5% of false positive results, but the merger of the NT screening with β-hCG and PAPP-A testing increases the detection rate to 90%. We present the case of a fetus with a NT of 49 mm detected at the first trimester ultrasound morphologic exam. The Kryptor test revealed a 1:35 risk for Trisomy 13 and 1:721 for Trisomy 18. We report the case of an investigated pregnancy with a NT of 49 mm detected at the first trimester ultrasound exam, with a risk of 1:35 for Trisomy 13 and 1:721 for Trisomy 18 calculated at the Kryptor test. A chorionic villus sampling was recommended and performed with a result of 46XY normal karyotype. The particularity of this case is represented by the increased nuchal translucency as well as an increased risk for trisomy 13 and 18 in a normal karyotype fetus that had a normal development in the second and third trimester with no pregnancy complications arising.

OC127: Increased nuchal translucency and distended jugular lymphatic sacs by first-trimester ultrasound

2004 ◽  
Vol 24 (3) ◽  
pp. 250-251
Author(s):  
M. Bekker ◽  
M. C. Haak ◽  
M. Rekoert-Hollander ◽  
J. Twisk ◽  
J. M. G. van Vugt
Keyword(s):  
First Trimester ◽  
Nuchal Translucency ◽  
First Trimester Ultrasound ◽  
Increased Nuchal Translucency

Monozygotic Twins Discordant for Trisomy 13

2017 ◽  
Vol 20 (4) ◽  
pp. 340-347 ◽  
Author(s):  
Patrick McFadden ◽  
Sarah Smithson ◽  
Robert Massaro ◽  
Jialing Huang ◽  
Gail T Prado ◽  
...  
Keyword(s):  
Uniparental Disomy ◽  
Monozygotic Twins ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Trisomy 13 ◽  
Ultrasound Finding ◽  
Umbilical Cord Cyst ◽  
First Trimester Ultrasound ◽  
Mosaic Trisomy ◽  
Increased Nuchal Translucency

Monozygotic twins with discordant karyotypes for trisomy 13 are rare. We report a case of a spontaneously conceived pregnancy who presented with first-trimester ultrasound finding of umbilical cord cyst and increased nuchal translucency in Twin A and no abnormalities in Twin B. Amniocentesis revealed 47,XY,+13 karyotype in Twin A and 46,XY karyotype in Twin B. Selective fetal reduction was performed for Twin A. Twin B was delivered at 32 weeks gestation with normal phenotype. Peripheral blood karyotype revealed 15% mosaicism for trisomy 13 and skin fibroblast revealed 46,XY karyotype. The surviving twin will be monitored for potential complication of uniparental disomy 13 and mosaic trisomy 13. This case reinforces the need for early ultrasound and nuchal translucency measurements, especially in twin gestations.

scholarly journals Association Between First-Trimester Intrauterine Hematoma and Twin Pregnancy Outcomes: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Wanqing Ji ◽  
Jie Zheng ◽  
Weidong Li ◽  
Fang Guo ◽  
Bo Hou ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Odds Ratio ◽  
Vaginal Bleeding ◽  
Pregnancy Loss ◽  
Twin Pregnancy ◽  
Adjusted Odds Ratio ◽  
First Trimester ◽  
Multivariable Logistic Regression Analysis ◽  
Vanishing Twin Syndrome ◽  
Twin Pregnancies

Abstract Background: In recent years, we have found that first-trimester intrauterine hematoma in twin pregnancy has become increasingly common. The majority of studies on intrauterine hematoma have excluded twin pregnancies, while others did not differentiate between singleton and twin pregnancies. The associations in twin pregnancy are not clear. Therefore, the primary objective of our study was to examine the associations between first-trimester intrauterine hematoma and pregnancy outcomes in twin pregnancy. Material and methods: 1020 twin pregnancies in women who underwent a routine examination from January 2014 to December 2018 were enrolled. According to the presence or absence of intrauterine hematoma, we compared the baseline data and pregnancy outcomes between two groups. Multivariable logistic regression analysis was used to adjust for possible confounding factors. Results: A total of 209 patients (21.3%) developed intrauterine hematoma in the first trimester. First-trimester intrauterine hematoma was significantly associated with increased odds of miscarriage (adjusted odds ratio 14.27, 95% CI 8.25-24.70) and the vanishing twin syndrome (adjusted odds ratio 3.26, 95% CI 1.11-4.61). However, It did not have increased odds of adverse pregnancy outcomes after 20 Weeks of Gestation .In the final regression model analysis, the associations of hematoma with previous miscarriage history, accepted assisted conception, accompanying vaginal bleeding and miscarriage and vanishing twin syndrome were no longer significant. No association was found between hematoma size or the presence of vaginal bleeding and the risk of pregnancy loss or the vanishing twin syndrome before 20 weeks of gestation (P>0.05). Conclusion: In women with twin pregnancies, the presence of intrauterine hematoma in the first trimester was associated with one or both fetal losses before 20 weeks of gestation. However, chorionicity in twins, the conception method, the intrauterine hematoma size and the presence of vaginal bleeding were not independently associated with pregnancy loss.

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