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Q. My NT scan report showed a thickness of 3 to 5 mm. Is this a case of high-risk pregnancy?

Answered by
Dr. R Balakrishnan Menon
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 11, 2017

Hello doctor,

I am a 33 year old female, who has a 5 year old baby girl. I had two miscarriages, one two years back at 11 weeks, and one last year at nine weeks. Now, I am three months pregnant, and I had a NT scan, which showed a thickness of 3 to 5 mm. Is this a case of high-risk pregnancy? Does it show any abnormality? Please let me know.

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#

Hi,

Welcome to icliniq.com.

How are you doing? Let me put forth few facts.

Your age is in normal limits and not in high-risk for anomalies or genetic problem. Only after 37 to 40 years it is high-risk. You do not seem to have any medical complications.

You have one 5 year old child, so the chance of next healthy pregnancy is very high, both of you have proved your capability to have children. I know you had two bad incidents, but accidents do occur.

Let me explain about NT (nuchal translucency), it shows the thickness behind the neck of the baby, which indirectly increases when baby has a genetic problem, we use it to screen for Down's syndrome, also called Mongolism or Trisomy 21. It can also diagnose problems like cardiac problems, musculoskeletal and lymphatic abnormalities in the baby. Since the baby's growth is matching with gestational age, only Down's syndrome has to be thought.

  • In Down's syndrome, the nasal bone is absent, and the ductus venosus blood flow is abnormal. In your report, the doctor very clearly mentioned these two are normal.
  • No one gives a report of 3 to 5 mm. It can be 3 mm or 5 mm, and I doubt if the doctor has taken a proper measurement. If I may suggest, meet a high-risk obstetrician or very experienced radiologist for a repeat scan. You can ask for a 3D scan to rule out any anomalies and also take a proper measurement.
  • If you still have doubt, then have an MRI, it is safe for baby. If any abnormalities are detected, then you will be given the option to abort. If the NT is confirmed as high, have an amniocentesis, where the fluid around the baby will need to be aspirated and tested for any genetic abnormality.

Hopefully, with God's grace, I am sure the reading will be normal and your pregnancy will proceed normally. Hope I have clarified your query, do write back. All the best.

For more information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hello doctor,

Thank you for your suggestions. I had double mirror test done, and I am sending you the copy of it. Can you please explain the findings? Is there any risk indicated in the report? Thank you.

#

Hello,

Welcome back to icliniq.com.

Nice to hear back from you. I have seen the attached reports (attachment removed to protect patient identity).

  • In the results, you can clearly see that the double marker test shows the MoM (multiples of median), which is significant only if the risk ratio is less than 1 in 250, which means you are 1 in 250 people. But as per calculations, you are 1 in 10,000. So, you are absolutely fine.
  • It just substantiates my theory that the report is wrong. Just have a repeat scan from a more reliable area. That will put your mind at rest. The result is absolutely fine, just relax.

Hope I have been of help to you, do write back. All the best.

For further queries consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

Thanks a lot. I will get back to you once I get the scan done. But sir, I was not able to understand about Down's syndrome. It was not mentioned in the report. Only trisomy 18, 21, and 13 were mentioned.

#

Hi,

Welcome back to icliniq.com.

  • There are many genetic anomalies, among which Down's syndrome is the most common, and it is not fatal, I mean the baby will not die. Others are those, in which genetic problem is fatal and the baby die in the womb or within few days of birth.
  • Among all the genetic problems, the baby with Down's or Trisomy 21 has longer survival. They usually have an array of problems like low IQ, heart and kidney problems. They survive up to the 50s only. They have a Mongolian look, that is, the lateral part of the eyebrow is pulled up.
  • They are happy kids, do not speak more, keep smiling and walk slowly. You would have seen them being taken around by parents. They cannot take care of themselves.

Do write back if any more queries. All the best.

For more information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hello doctor,

Thanks for the response. It is nice to see the message. I feel good now. Thank you for all your help.

#

Hi,

Welcome back to icliniq.com.

  • Just keep it in mind that you and your baby are absolutely fine. Any doctor or a report cannot do you any harm, there are many things out of our control. Keep faith in God, he will take care of you and your baby. Never get stressed or think you have a problem.
  • Take every day as it comes, my prayers are with you. Hope I could build some courage and positive thoughts in you. If you need any help, do write back. All the best.

For further queries consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hello doctor,

Thanks for all the support. Your messages built a lot of confidence in me. Once again thanks for taking time out for me.

#

Hi,

Welcome back to icliniq.com.

Hope everything's going fine. Thank God I could be of some help to you. Feel free and do ask questions as many as you want at any time. There is nothing more satisfying than giving some peace of mind to someone. All the best.

For further queries consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

I got NT scan done once again and sending you the reports. Please have a look at it and let me know your opinion. After seeing the reports, my doctor asked to go for NIPT test. The radiologist has done the risk assessment according to the old double mirror test. Thank you.

#

Hi,

Welcome back to icliniq.com.

Your results are very contradicting again (attachment removed to protect patient identity). Let me explain it to you.

Your age is atlow risk of less than 35 years. Your previous and present scan is showing normal nasal bone and ductus venosus blood flow.

Double marker blood test values are within normal limit.

There are no other problems in the scan. The only issue again is the increase in NT value. Now the best, final and most confirmatory method would be either go for amniocentesis or NIPT.

  • The expert will pass a needle into the sac of baby and pull some fluid out. It is not a painful procedure, and you will have to be in the hospital for a day. This fluid is tested for the cells, which will give the karyotype or the genetic makeup. If abnormal, it will be readily seen in the cells and is confirmatory.
  • The other method will be to take these cells from mother's blood. These cells are to be used for genetic analysis, NIPT (noninvasive prenatal test).
  • I would be advisable to go for either of these based on the facility and expertise available. Please make all the doubts and enjoy the days of pregnancy instead of thinking of what the next problem would be. Take care.

For further doubts consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist


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