title: Are First Trimester Nuchal Septations Independent Risk Factors for Chromosomal Anomalies?
abstract: OBJECTIVE
  There is conflicting information regarding the role of nuchal septations during first-trimester genetic screening. This study was designed to determine whether nuchal septations are risk factors for chromosomal anomalies, independent of increased nuchal translucency (NT), in the first trimester of pregnancy.
  
  
  METHODS
  This retrospective cohort study included all women who underwent first-trimester genetic screening between November 2011 and December 2014. The 95th percentile for the NT measurement was calculated for each gestational week. A multivariable logistic regression analysis was performed to determine whether the visualization of nuchal septations was an independent risk factor for chromosomal analysis while controlling for confounding variables. P < .05 was considered significant.
  
  
  RESULTS
  Chromosomal abnormalities were present in 1.0% of the population (33 of 3275). The prevalence of chromosomal abnormalities was significantly higher among fetuses with nuchal septations compared to fetuses with normal NT without septations (P < .001) and those with NT above the 95th percentile without septations (P < .001). The sonographic evidence of septations was associated with high risk of chromosomal abnormalities (odds ratio, 40.0; 95% confidence interval, 9.1-174.0) after controlling for NT measurements and other confounding variables.
  
  
  CONCLUSIONS
  Visualization of nuchal septations during first-trimester genetic screening is a powerful risk factor for chromosomal anomalies, independent of increased NT.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas, USA.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Mack
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas, USA.
authors.forename: Wesley
authors.initials: W
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas, USA.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Mastrobattista
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Belfort
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas, USA.
authors.forename: Ignatia B
authors.initials: IB
authors.lastname: Van den Veyver
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas, USA.
authors.forename: Alireza A
authors.initials: AA
authors.lastname: Shamshirsaz
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas, USA.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Ruano
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas, USA.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Sanz Cortes
authors.affiliation: Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Andres
authors.initials: A
authors.lastname: Espinoza
authors.affiliation: Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Arame
authors.initials: A
authors.lastname: Thiam Diouf
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas, USA.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Espinoza
mesh_terms: D000328:Adult; D002869:Chromosome Aberrations; D025063:Chromosome Disorders / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors
keywords: cystic hygroma; first-trimester screen; nuchal septations; nuchal translucency; obstetric ultrasound