Download PDF
Am J Perinatol 2016; 33(05): 486-489
DOI: 10.1055/s-0035-1566248
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Comparative Analysis of Two- Versus Three-Dimensional Sonography for Nuchal Translucency Measurement

Adeeb Khalifeh
1   Division of Maternal Fetal Medicine, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
,
Stuart Weiner
1   Division of Maternal Fetal Medicine, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
,
Vincenzo Berghella
1   Division of Maternal Fetal Medicine, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
,
Steven Scott
2   Division of Maternal Fetal Medicine, Lankenau Medical Center, Wynnewood, Pennsylvania
,
Andrew Gerson
2   Division of Maternal Fetal Medicine, Lankenau Medical Center, Wynnewood, Pennsylvania
› Author Affiliations
Further Information

Publication History

14 May 2015

24 September 2015

Publication Date:
03 November 2015 (online)

    Permissions and Reprints

Abstract

Objective The aim of this article is to test the hypothesis that three-dimensional (3D) sonography is correlated to the two-dimensional (2D) sonography for nuchal translucency (NT) measurement during first trimester screening (FTS).

Methods We performed a prospective observational study on patients presenting for FTS. Three NT measurements were performed using the current standardized 2D method at the midsagittal planes, and NT sonography was then repeated for each case using 3D sagittal and axial plane. The Kruskal–Wallis test and the Spearman rank correlation were used to evaluate the relationship between 2D and 3D NT methods of measurement. A p-value <0.05 was considered significant.

Results The study included 366 patients with singleton pregnancies. Mean maternal age was 31.2 years, and mean gestational age was 123/7 weeks. The mean maximal NT measurement for 2D and 3D sagittal and axial planes were 1.65, 1.70, and 1.66 mm, respectively (p = 0.42). The Spearman rank correlation of 2D sagittal plane sonography with 3D sagittal and axial planar sonography was 0.73 and 0.68, respectively (p < 0.001).

Conclusion 3D NT measurement appears to be a tool highly correlated to the conventional 2D sonographic approach. This may be useful in selected cases in which there is difficulty in obtaining optimal 2D measurements of the NT space.

Keywords

nuchal translucency - two-dimensional sonography - three-dimensional sonography
 

  • References

  • 1 Nicolaides KH, Azar G, Byrne D, Mansur C, Marks K. Fetal nuchal translucency: ultrasound screening for chromosomal defects in first trimester of pregnancy. BMJ 1992; 304 (6831) 867-869
    CrossrefPubMedGoogle Scholar
  • 2 Nicolaides KH, Brizot ML, Snijders RJ. Fetal nuchal translucency: ultrasound screening for fetal trisomy in the first trimester of pregnancy. Br J Obstet Gynaecol 1994; 101 (9) 782-786
    CrossrefPubMedGoogle Scholar
  • 3 Taipale P, Hiilesmaa V, Salonen R, Ylöstalo P. Increased nuchal translucency as a marker for fetal chromosomal defects. N Engl J Med 1997; 337 (23) 1654-1658
    CrossrefPubMedGoogle Scholar
  • 4 Malone FD, Canick JA, Ball RH , et al; First- and Second-Trimester Evaluation of Risk (FASTER) Research Consortium. First-trimester or second-trimester screening, or both, for Down's syndrome. N Engl J Med 2005; 353 (19) 2001-2011
    CrossrefPubMedGoogle Scholar
  • 5 Souka AP, Von Kaisenberg CS, Hyett JA, Sonek JD, Nicolaides KH. Increased nuchal translucency with normal karyotype. Am J Obstet Gynecol 2005; 192 (4) 1005-1021
    CrossrefPubMedGoogle Scholar
  • 6 Carvalho JS, Senat MV, Schwarzler P, Ville Y. Increased nuchal translucency and ventricular septal defect in the fetus. Circulation 1999; 99 (19) E10
    CrossrefPubMedGoogle Scholar
  • 7 Hyett JA, Perdu M, Sharland GK, Snijders RS, Nicolaides KH. Increased nuchal translucency at 10-14 weeks of gestation as a marker for major cardiac defects. Ultrasound Obstet Gynecol 1997; 10 (4) 242-246
    CrossrefPubMedGoogle Scholar
  • 8 D'Alton ME, Cleary-Goldman J. Education and quality review for nuchal translucency ultrasound. Semin Perinatol 2005; 29 (6) 380-385
    CrossrefPubMedGoogle Scholar
  • 9 Abuhamad A. Technical aspects of nuchal translucency measurement. Semin Perinatol 2005; 29 (6) 376-379
    CrossrefPubMedGoogle Scholar
  • 10 Abele H, Wagner N, Hoopmann M, Grischke EM, Wallwiener D, Kagan KO. Effect of deviation from the mid-sagittal plane on the measurement of fetal nuchal translucency. Ultrasound Obstet Gynecol 2010; 35 (5) 525-529
    CrossrefPubMedGoogle Scholar
  • 11 Schmidt P, Staboulidou I, Elsässer M, Vaske B, Hillemanns P, Scharf A. How imprecise may the measurement of fetal nuchal translucency be without worsening first-trimester screening?. Fetal Diagn Ther 2008; 24 (3) 291-295
    CrossrefPubMedGoogle Scholar
  • 12 Evans MI, Van Decruyes H, Nicolaides KH. Nuchal translucency measurements for first-trimester screening: the ‘price’ of inaccuracy. Fetal Diagn Ther 2007; 22 (6) 401-404
    CrossrefPubMedGoogle Scholar
  • 13 Thornburg LL, Mulconry M, Post A, Carpenter A, Grace D, Pressman EK. Fetal nuchal translucency thickness evaluation in the overweight and obese gravida. Ultrasound Obstet Gynecol 2009; 33 (6) 665-669
    CrossrefPubMedGoogle Scholar
  • 14 Wax JR, Pinette MG, Cartin A, Blackstone J. The value of repeated evaluation after initial failed nuchal translucency measurement. J Ultrasound Med 2007; 26 (6) 825-828 , quiz 829–830
    PubMedGoogle Scholar
  • 15 Bromley B, Shipp TD, Mitchell MA, Benacerraf BR. Tricks for obtaining a nuchal translucency measurement on the fetus in a difficult position. J Ultrasound Med 2010; 29 (8) 1261-1264
    PubMedGoogle Scholar
  • 16 Kurjak A, Kupesic S, Ivancić-Kosuta M. Three-dimensional transvaginal ultrasound improves measurement of nuchal translucency. J Perinat Med 1999; 27 (2) 97-102
    CrossrefPubMedGoogle Scholar
  • 17 Eppel W, Worda C, Frigo P, Lee A. Three- versus two-dimensional ultrasound for nuchal translucency thickness measurements: comparison of feasibility and levels of agreement. Prenat Diagn 2001; 21 (7) 596-601
    CrossrefPubMedGoogle Scholar
  • 18 Chung BL, Kim HJ, Lee KH. The application of three-dimensional ultrasound to nuchal translucency measurement in early pregnancy (10-14 weeks): a preliminary study. Ultrasound Obstet Gynecol 2000; 15 (2) 122-125
    CrossrefPubMedGoogle Scholar
  • 19 Paul C, Krampl E, Skentou C, Jurkovic D, Nicolaides KH. Measurement of fetal nuchal translucency thickness by three-dimensional ultrasound. Ultrasound Obstet Gynecol 2001; 18 (5) 481-484
    CrossrefPubMedGoogle Scholar
  • 20 Shipp TD, Bromley B, Benacerraf B. Is 3-dimensional volume sonography an effective alternative method to the standard 2-dimensional technique of measuring the nuchal translucency?. J Clin Ultrasound 2006; 34 (3) 118-122
    CrossrefPubMedGoogle Scholar
  • 21 Cho HY, Kwon JY, Kim YH , et al. Comparison of nuchal translucency measurements obtained using Volume NT(TM) and two- and three-dimensional ultrasound. Ultrasound Obstet Gynecol 2012; 39 (2) 175-180
    CrossrefPubMedGoogle Scholar
  • 22 Michailidis GD, Economides DL. Nuchal translucency measurement and pregnancy outcome in karyotypically normal fetuses. Ultrasound Obstet Gynecol 2001; 17 (2) 102-105
    CrossrefPubMedGoogle Scholar
  • 23 Nicolaides KH, Heath V, Cicero S. Increased fetal nuchal translucency at 11-14 weeks. Prenat Diagn 2002; 22 (4) 308-315
    CrossrefPubMedGoogle Scholar
  • 24 Snijders RJ, Noble P, Sebire N, Souka A, Nicolaides KH ; Fetal Medicine Foundation First Trimester Screening Group. UK multicentre project on assessment of risk of trisomy 21 by maternal age and fetal nuchal-translucency thickness at 10-14 weeks of gestation. Lancet 1998; 352 (9125) 343-346
    CrossrefPubMedGoogle Scholar
  • 25 Nicolaides KH, Syngelaki A, Ashoor G, Birdir C, Touzet G. Noninvasive prenatal testing for fetal trisomies in a routinely screened first-trimester population. Am J Obstet Gynecol 2012; 207 (5) 374.e1-374.e6
    CrossrefPubMedGoogle Scholar