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Thick NT at 22 week scan

(24 Posts)
shininghero Sun 10-Feb-08 17:33:23

Hi all,
I am 31, my wife is 37, expecting twins (currently 22w) after our 3rd ICSI and several miscarriages... At the 12 week scan, we declined a NT test that would indicate risk rating for Downs etc, so I don't know what the thickness was at 12 weeks.

Now at the 22week scan, the NT thickness is came in at 3.6mm and 4.0mm. Even if there was something at 12weeks, I thought they were meant to disappear over time. Now we are worried sick and dread to think of the consequences. The sonographer checked for anomalies and she said they were both fine (so far?).

Has anyone come across this before? Can someone point me in the right direction of websites that provides info on NT thickness at various stages of pregnancy?

horseshoe Sun 10-Feb-08 17:43:54

Just looking at my notes.

At my 12 week scan the NT was 1.6mm and then at 20 week scan it was 3.1mm.

No reason to think we are high risk

horseshoe Sun 10-Feb-08 17:51:03

Just found through search engines that it should be no more that 3mm for your first scan and no more than 6mm for your second.

Sounds like everything is fine but I am sure someone will be along soon to confirm

poppy34 Sun 10-Feb-08 17:51:06

Isn't the window for using NT to test for Downs etc incredibly small (Something like between 11.5 and 13.5 weeks) so at 20 week scan I think you're beyond time where you can read anything re downs etc.

See here [http://en.wikipedia.org/wiki/Nuchal_translucency
link]] and here fmc

shininghero Sun 10-Feb-08 18:01:27

Thanks for the reply everyone. This is noted in the wiki link provided...

"The translucent area measured (the nuchal translucency) is only usable to measure between 10 and 14 weeks’ gestation, when the fetal lymphatic system is developing and the peripheral resistance of the placenta is high. After 14 weeks the lymphatic system is likely to have developed sufficiently to drain away any excess fluid, and changes to the placental circulation will result in a drop in peripheral resistance. So after this time any abnormalities causing fluid accumulation may seem to correct themselves and can thus go undetected by making a nuchal scan."

I don't really understand the section referring to 'peripheral resistance'...but does it all just mean that normally the thickness should decrease as the fluid is drained? I've read a lot of threads about the thickness disappearing altogether. Just worried sicksad

Chooster Sun 10-Feb-08 18:40:25

I can only add that my DS2 had a very very high NT measurement at the 12 week scan and I was re-assured by mid-wives and consultants that it can be high and not be an indicator of an issue. I was told of some cases where NT is high right through to birth. Pregnancy is a real minefield full of incertainties so I really feel for you. But the measurements dont sound high and at least you were not given any warnings at teh 20 weeks scan. Perhaps your wifes mid-wife could help wiht sources of info??

horseshoe Sun 10-Feb-08 19:14:02

There are other signs of DS such as 3 out of 4 babies dont show a nasal bone.

Found this on midwivesonline:

a. Nuchal translucency (NT) which is done at 10-14 weeks gestation and involves measuring the subcutaneous fluid at the back of the neck of the baby. The increased NT in combination with other factors such as mother’s age can be used for detecting genetic abnormalities such as Down syndrome.
b. Nuchal fold scan is a measurement of skin and fat at the back of fetal neck, which is done at about 20 weeks gestation. This is also used as a marker to screen for possible abnormalities in babies such as Down syndrome. These are used in combination with other risk factors (such as NT) to identify possibility of chromosomal abnormalities.

On my notes the 12 week is called Nuchal Transluncency and on the 20 week it is called Nuchal Fold thickness.

Double check your notes. Does it def say NT on the 22 week scan?

TotalChaos Sun 10-Feb-08 19:16:32

Did the sonographer point out the nuchal fold as being in anyway concerning? I am a little confused by your post, as to what drew your attention to the nuchal fold in the first place. I really do think it's better for you and/or dw to insist on speaking to a midwife, if not a doctor tomorrow to ask for an explanation, rather than trying to google.

Onlyaphase Sun 10-Feb-08 19:24:27

Agree with Totalchaos - what is the reason for your concern? Who suggested this was a problem to you?

Millarkie Sun 10-Feb-08 19:31:18

NT of under 6mm is perfectly normal at 22 weeks!

shininghero Sun 10-Feb-08 20:27:52

The sonographer just did her job by taking measurements and just mentioned "they're fine" and did not draw any attention to anything specific. the consultant was too busy to look thru the scan results in detail but wife is pretty upset as she expected the 'neck fat' to be non-existant. is this just paranoia? I too thought nuchal fold/NT was a good indicator for abnormaly risk.

>Millarkie - >6mm at 22 weeks - is that something your doctor mentioned?

i will definitely take your advice and try to speak to the consultant this week as the next scan is 4 weeks away.

shininghero Sun 10-Feb-08 20:32:20

TotalChaos - sorry, to clarify the 3.6mm and 4.0 measurements were for Nuchal Fold Thickness.

Is there such thing as 'normal range' for Nuchal Fold Thickness at 22 weeks?

mollymawk Sun 10-Feb-08 20:42:01

I can't say I know anything about nuchal measurements, but I had my 22 wk scan recently and there are lots of things the sonographer checks for that are "markers" for Down's syndrome. I am sure that the sonographer would have pointed these out to you and sent you to talk to a midwife/doctor if there had been anything to concern him/her.

Mum1369 Sun 10-Feb-08 20:50:36

Hi
Not an expert but agree with mollymawk. As I remember, the later scan indicators are different to nuchal measurements. Nose bone and (little) finger (I think) - and these things are reasonably apparent at 22 weeks - therefore (and I am assuming) that if these were indicative of a problem, then the sonographer would have referred you at that point for further investigation / amnio (obviously if you wanted that)- I don't think they would have left you to wait until your next normal scheduled scan.
If you are worried, I would pay for a private scan (don't know where you are but google your area)- they can fit you in asap and would put your minds at rest.

Aitch Sun 10-Feb-08 20:59:42

aren't there other markers as well? sandal toe? i think there's about 6 things, my friend had an anomaly scan and mentioned them. it's entirely possible you're getting upset over nothing, but you should call them tomorrow so you can relax. smile

cityangel Sun 10-Feb-08 21:44:47

We had a 12 week Nuchal at the FMC (see link Poppy 34 posted. They were very professional and we chose them through recommendations on mumsnet. They measured other things in combination with the fluid such as the nose bone measurements and a blood test. So I agree with Mum1369 on the results being taken in conjunction with the Nuchal information.

The next scan we are booked in is the Anomaly scan at 20 weeks one (£200):
www.fetalmedicine.com/f-fmc-scans.htm

I agree that should ask for more answers than they have given you. Even if they were busy they should have made time to discuss any of your concerns and made it clear to you if they were concerned with the measurements.

If you need further investigation then they should make it clear what possible scan, blood test and amnio readings could tell you
at your current stage of pregnancy and the associated risks.

If it is an option to you I would contact the FMC to see what private scan/blood tests are available to you as they have a lot of experience in this field. Even if you don't plan to have a scan there I think they would be very helpful in telling you your scan/test options over the phone and then you could pursue these locally.

I hope it works out.

yurt1 Sun 10-Feb-08 21:47:37

NUchal measurements tell you nothing at 20 odd weeks.

Millarkie Mon 11-Feb-08 11:06:23

Yurt - nuchal oedema at 20+ weeks, giving a measurement of over 6mm, would be an indicator of Turner's syndrome, trisomy or undiagnosed heart problems.
Shininghero - if you haven't spoken to your consultant yet - try searching on pubmed.com for clinical papers.

hatrick Mon 11-Feb-08 11:36:00

Message withdrawn at poster's request.

shininghero Mon 11-Feb-08 21:01:28

Thanks for all your replies. I still haven't been able to catch our consultant so I will keep trying this week for his feedback.

At the moment I am slightly relieved to hear that 3.6mm and 4.0mm at 22weeks isn't detrimental. I have been searching the net for medical papers on this topic but the majority of them only posts data on 11-14 weeks so I will keep searching for this too. Thanks again for your input, i will sleep easy tonightwink

mumofk Tue 12-Feb-08 09:21:18

Shininghero- what you are describing is a normal finding. Up to 6 mm is a normal finding at the 20 week anomaly check (we normally aim to do it 20-23 weeks round here). Only speaking to the people caring for your wife (Dr/midwife/possibly the sonographer, depending on the centre)will truly be able to reassure you, but they would have said if there was anything to worry about.Skin oedema at the back of the head would be a significant finding, not just for downs but for other things, so it would have been mentioned had there been any cause for concern. You will always have some thickness there, as, after all it is a measurement of the skin thickness- so it would not be right for it to dissapear completely. (Some places will not quote measurements for you though, as they only measure it if it looks abnormal).
Hope you get to speak to someone soon- you shouldn't need to speak to just your consultant as anyone clinical at your centre should be able to reassure you on this one (just don't want you to wait unneccesarily just to speak to one person when others may be able to help).
I'm a sonographer in Yorkshire, so not just trying to give you completely random advice!
mumofk

shininghero Tue 12-Feb-08 20:38:28

>mumofk
Many thanks for your reply. it is extremely comforting to hear from a practicing professional. i guess all this came about as we declined the 12week check hence we didn`t know the actual measurement. we`ve had several miscarriages before so i guess we are ever more conscious of the well being of the developing babies. thank you very much!

angandmick Sun 13-Jan-13 19:28:27

Hi Everyone i hope my story helps someone out there as all i did was search the net for answers...

i found out i was pregnant in feb 2012 and we was so excited and happy, we had our fist 12 week scan which was great and choose not to have the downs test, at 20 weeks we where deverstated as at the scan we were told the nucal fold was measuring 7.2 and it should not measure more that 6mm and that this was a marker for Downs, we where sent to a specialtist senogrpher who confirmed the measurment, we then was sent home with an appointment at 32 weeks!!!! as you can imagine we where worrying all the way through the pregnancy looking up how to look after a downs baby and planning just incase, we went back at 32 weeks and was told he had no more markers just the nucal fold and to try not to worry as there is only a 3% chance as he had no othere markers.. to bring some good news we decided to find out the sex that day and we was told we where having a gorg little boy, we came to terms that he may be downs and couldnt wait for him to arrive... WELL he did arrive safe and sound on his due date which was amazing in itself but he was totally healthy and not downs he just has a bit of a fat neck for some reason which is cute xxxx but you know what!!! that day was amazing and i tell you somthing ... it really doesnt matter downs or not you will love them just as much, the day they arrive is out of this world and it will be the last think on your mind, your just glad to see them and touch them xxxx

i no its hard but please try to not worry and have a lovley pregnancy as i let it spoil mine and i wish i hadnt x ( to be honest i think if you opt out of the injection for downs at 12 weeks they shouldnt tell you about 1 marker as you have already said you dont want to know)

good luck and be strong im sure you will have a healthy little bundle of joy to cuddle after all this stress xxxxxxx

take3 Sun 13-Jan-13 20:31:45

I am always confused when they say 'high risk'... actually their 'high risk' is often quite low risk.... 1:150 is considered high... but when it comes to doing an amnio, that is counted as low risk when 1:100 miscarry.... so that is certainly not low risk if the nuchal 1:150 is high!
We had friends who were given a 1:5 extremely high risk of downs.... well, that is an 80% chance that all is well - and it was all fine. It is easy to over-worry and get things out of perspective.

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