Nuchal measurement 4.2mm at 11 weeks

[Dualta]

Hi everyone. I had a worrying nuchal result at 11 weeks as part of the harmony test. The sonographer was very cagey and said just wait for the results and see. I'm just unable to think of anything else. I'm 36 with two other children. I've been reading all the kind words of support to everyone from the group here. They didnt do the hcg/papp-a bloods as harmony is being done anyway. But from what I've been reading online this level of NT would be high risk on its own given the NT grows with the baby. Just wondering what outcomes you may have had with a similar NT result. They recommended an NT rescan in 2 weeks in addition to the harmony test. The wait is terrible

Hi I just wanted to say I'm in a similar situation. I've just had an early scan at 9. 1/2 weeks and was told there was a lot of fluid at the back of baby's head and neck. They didn't give me the measurement but from what I saw I think it must be quite high. I'm now thinking of having the harmony test but thinking if the nt is that high would I just be high risk based on that alone without bloods?

Sorry I've not helped you and hopefully someone more knowledgable will have some advice. I just wanted you to know you're not alone.

Thanks Liesel for letting me know you are in the same place and sharing your story. I'm sorry you are going through this too, it is hard. Did they say anything to you about how early your scan was? I am in Ireland and theybsaid they only factor in nuchal measurements after 11w2d here ao an earlier result wouldnt be counted yet. But i think she was just trying to reassure me until i got the Harmony test back. She also said that even if Harmony is clear for trisomies they would keep an eye on the baby for heart problems with scans at 15 and 20 weeks.

The Harmony is very expensive. But I think it rules out the need for CVS or Amnio (im only really finding out from reading others' posts here). Perhaps someone will be along to tell us more

Hello both,

Sorry to hear that your scans gave some cause for concern. Harmony is a screening test which has a high detection rate for three of the most common chromosomal disorders - Downs, Edwards, Patau. It will give you a much clearer indication (either very high, or very, very low) as to whether your baby has one of these disorders than the standard NT + plus screening offered by the NHS, which generates a much broader spectrum of probability. It is not a diagnostic test however, so if the Harmony test indicates that your baby has, for example, Patau Syndrome, you would still need a CVS or Amnio to confirm this. Harmony also doesn't test for all chromosomal abnormalities, so if it came back clear but subsequent scans revealed problems indicative of a chromosomal disorder you might still be advised to have an amnio. A high NT can also be indicative of a virus, or a structural anomaly unrelated to a chromosomal problem (e.g. an issue with the heart). However, many babies with an elevated NT are fine. It's partly about the size of the NT measurement: A consultant told me at the NT screening for my first pregnancy that the risk of my baby having a chromosomal disorder was more than 70%, but then my baby's NT was massive (just under 7mm, I think). It didn't end well. However, the same chart puts the risk of a chromosomal disorder when the NT measures 4.2mm at around 20%, with 70% resulting in healthy babies, and a further 10% being unaffected by chromosomal disorders, but having some other kind of anomaly. Some anomalies can be fixed, and chromosomal disorders also vary hugely in the way they affect people's health and quality of life, so even if you fall into that 20% or 10% it's not necessarily awful news. It's horrible to have to wait and see how things develop, but Dualta it does sound like there's a very good chance that your baby will prove to be healthy. I really hope this is the case, and that your Harmony results are all low risk.

best of luck to the both of you

Thank you offbeatgirl so much for your response - and I am so sorry to hear that you had a baby with this problem. I really appreciate you sharing the full view - do you have a link to the chart that you mentioned.
I find out either Thursday or Friday when the results come through to Dublin so I will let you know what the update is. I had wondered whether the Harmony ruled out amnio if the odds were so high. And I guess amnio gives a broader spectrum result, so Harmony is another step on the journey to ruling things out more than anything I suppose.
I don't know much about a virus causing a high NT, that is really interesting and the whole house has been sick with a bug, I will look into that.
Thank you again for your support. Dualta

Hi Dualta,

The table is on page 72 of this PDF (although I suspect you'll find it elsewhere too):
www.fetalmedicine.com/synced/fmf/FMF-English.pdf
The author runs the fetal medicine in London so an expert in the field.

I had blood tests for CMV and parvovirus (aka slapped cheek) which apparently were possible causes of the high NT measurement. I don't know if this is a more common cause when you're dealing with really high NT results as was my case? My baby had a cystic hygroma - in other words not just fluid behind the neck but a fluid-filled membrane which ran from crown to rump. Turned out to be Turner Syndrome, which sadly few babies survive to term with (although those that do then tend to have a good quality of life).

Harmony doesn't rule out all chromosomal problems, but if you come back as very low risk for the three chromosomal disorders it does test for that's very positive. If you get good news from the Harmony test then it may be a case of keeping an eye on your baby's condition as the pregnancy progresses. I spoke to a midwife in my second (thankfully uneventful) pregnancy who had a high NT score in her own pregnancy. She told me that she worried her way through the whole pregnancy, but her son was born perfectly healthy. Statistically speaking, that's a more likely outcome for you than what happened to me.

Fingers crossed that you get good news with the Harmony results.

Thanks for the link to that report offbeatgirl. I'm going to the FMC tomorrow for a scan and harmony so we'll see what they have to say.

Dualta when are you due to get your harmony results? The wait is horrible isn't it. I guess you've just got to take it one step at a time.

Hi everyone. Thanks for the kind words. I am expecting a phone call either Thursday or Friday. Days couldn't pass any more slowly. Liesl I hope you get aome reassurance tomorrow please let us know how you get on. I will post here what they say. Hope its just a case of monitoring. Ivw read so much online now ive totally freaked out. Fingers crossed for us all.

Liesl how did it go for you today? Hope you are ok.

Hi Dualta

I'm feeling a lot more positive than I was. The lady that scanned us today was really nice and said although she could see the fluid which she measured at 3.2mm that as I'm still only 10 wks it's too early to draw any conclusions from it. She told me I was doing the right thing getting the harmony done and I just need to wait 2 weeks for the results and have the 12wk nt scan and take it from there. She told me just to try not to worry and there's a chance it could be nothing. Equally she said even for women that don't have this level of fluid at 10 wks there's still no guarantee that they won't be high risk by 12 wks.

I hope you're doing ok and that you get some good news tomorrow or Friday. It really is a worrying time but you'll have your answers soon enough.

Im so glad you had a reassuring appointment Liesl it will make all the difference to your week ot two weeks' waiting for results. This week has been a bit of a rollercoastee but at least it has given me time to prepare myself either way and some thinking time. I also told my boss at work who was brilliant anout it and is giving me plenty of flexibility around all this. So that helps. I will let you know. Apparently they phone the minute results come through so it could be any time from am tomorrow. It really couldnt come sooner.

Hi ladies. My 12 week scan on Tuesday showed a 6mm cystic Hygroma. Third baby. No problems before. Seeing fetal medicine consultant tomorrow. All the info I read is bleak to say the least. It comes over me in waves. Haven't gone to work for the last few days so feel guilty about this too! So scared at prospect of having to have a medical top as just don't think I can cope with it but not sure surgical will be an option. So glad that I found this group as lots of very old stuff and info everywhere I have looked. Think I will be having CVS tomorrow too. Xx

Glad to hear that your appointment at the FMC was more positive Liesl, and I hope things are looking better for you by the 12 week scan. Fingers crossed for your harmony results, Dualta. Evs34 - I was in a similar situation to you and worried about a medical TOP, but in hindsight I'm glad that I went through with the tests and waited until I had a clear clinical picture before making a decision about the pregnancy. If I'd rushed to have a surgical TOP before being certain about my baby's prognosis - and a proportion of babies with an NT measurement of that size do turn out to be ok - I'd have regretted it later on. It's horrible though, and you certainly shouldn't feel bad about missing work. I put my feet up for a couple of days after the CVS and spent the time slumping on the sofa watching films.

Take care

Thanks offbeat xx

Evs34 oh what a worrying time for you. We can stay on here with you and offer aome small support but we are all able to empathise with your worry and uncertainty. It is so hard. How soon will you know the cvs result. Just offering all my thoughts. Thanks to offbeatgirl for your support its great to have your perspective. Thinking of you Evs

Still no word today. They said first thing in the morning..what a day of waiting. Cant wait for it to just be over.

Hi

Hi evs34 so sorry you find yourself in this situation. Good luck with the cvs tomorrow. I think I read the results come back in 3 days so hopefully you'll soon know if there is a problem or not. Fingers crossed for you there isn't. It's such a horrible time isn't but at least we can support each other through it.

Hi Dualta hopefully you'll get your harmony results first thing and the wait will be over. Fingers crossed for you too.

I've had my nhs scan date through today for 2 days before I get my harmony results and have a scan and nt at the FMC. Thinking its best to postpone the nhs one? Or do I need to even have it all if I'm having the same thing done privately?

Liesl i would think the harmony scan is thensame as the nhs scan so two says apart wont tell you much different. But definitely ask.

I had a call this morning and got good news the harmony test came back all low risk. So now we have to do a heart scan at 22 weeks butnthe relief is immense.

Dualta that's fantastic news you must be so relieved. Is the 22 wk heart scan the same as the 20wk anomaly scan or in addition? Did you find out the sex of your baby?

Evs34 how are you doing?

Hi liesl we are having another boy! How is everyone doing? I think there is an extra scan at 22 weeks

I'm hanging on in there. We go back to FMC for our harmony results and 12 wk nt scan on Wednesday morning. It can't come soon enough. I'm just worried that I've not prepared myself enough for bad news but trying to be positive has been the only thing that has got me through the past 12 days. Great news you're having a boy Dualta. Hope you've been able to put the worry behind you and just enjoy being pregnant.

I just wanted to update in case anyone with a similar concern reads this. After having a 3.2m nt at 10 wks at 12 wks it was 1.6m at its highest so nt doesn't necessarily always grow with the baby. My harmony came back low risk so all looking positive. They did the combined nt and that was low risk too. I'm going for my nhs scan on Friday so hopefully they'll say the same as FMC.