Increased nuchal translucency and congenital heart defects in a low-risk population.
OBJECTIVE
Increased first-trimester nuchal translucency (NT) is a possible marker for congenital heart defects in euploid fetuses. In this study, we wanted to determine the sensitivity for congenital heart defects using the 95th centile of the NT as a cut-off point.


METHODS
All women who booked for delivery in our hospital in the first trimester underwent NT measurement at a crown-rump length (CRL) of between 35 and 75 mm. In all euploid fetuses and newborns with isolated or associated CHD, NT was examined retrospectively and classified as normal (<95th centile according to CRL-dependent centiles in our own data) or increased (> or =95th centile).


RESULTS
From a total of 12,978 euploid fetuses screened, 27 had CHD (22 isolated and 5 cases associated with additional malformations). Moreover, 7 of the 27 fetuses also had increased NT (26%). Increased NT was significantly more frequent in fetuses with associated CHD (4/5) than in those with isolated CHD (3/22, Yates corrected chi2 p=0.012). In fact, the relative risk for CHD was 6.6 times higher in fetuses with increased NT compared to those with normal NT.


CONCLUSIONS
Increased NT for the detection of CHD performed less well than in other studies. Nevertheless, it can be used as an indication for fetal echocardiography.
Hafner
E
E
Ludwig Boltzmann Institute for Clinical Obstetrics and Gynaecology, Department Gyn/Obs, Donauspital am SMZ-Ost, Vienna, Austria. erich.hafner@smz.magwien.gv.at
Schuller
T
T
Metzenbauer
M
M
Schuchter
K
K
Philipp
K
K
D000293:Adolescent; D000328:Adult; D001317:Austria / Q000453:epidemiology; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging* / Q000196:embryology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies; D012307:Risk Factors; D016216:Ultrasonography, Prenatal / Q000592:standards*