Cnmnpcpsp

California Prenatal Screening Program CPSP FIRST TRIMESTER COMBINED = NT Plus 1 st Trimester Analytes FULL INTEGRATED = NT Plus 1st & 2 nd Trimester Analytes SERUM INTERGRATED = 1st & 2 nd Trimester Analytes Only QUAD SCREEN ONLY = 2 nd Trimester Analytes Only

NUCHAL TRANSLUCENCY (NT) What Is It? NT is the sonolucent zone at the posterior aspect of the fetal neck. This space represents the sonographic appearance of subcutaneous fluid behind the fetal neck.

NUCHAL TRANSLUCENCY “Normal” Size Changes with Gestational Age ,[object Object],[object Object],[object Object]

NUCHAL TRANSLUCENCY Increases with Gestational Age ,[object Object],CRL 2.7 1.9 84mm 14 2 / 7 weeks CRL 2.1 1.2 45mm 11 2 / 7 weeks 95 percentile (mm) Median (mm)

NUCHAL TRANSLUCENCY (NT) Why Measure It? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

NUCHAL TRANSLUCENCY Increase Size of NT Increase Risk of Genetic Birth Defect Obstet Gynecol:2006;107:6 75 > 8.5 65 ≥ 6.5 50 5.5 – 6.4 30 4.5 – 5.4 20 3.5 – 4.4 7 2.5 – 3.4 ½ are T 13, 18, 45x, Triploidy (%) 99 percentile = 3.4 mm (mm) ½ are T21 NT size mm

NUCHAL TRANSLUCENCY (NT) Why Measure It? ,[object Object]

NUCHAL TRANSLUCENCY Increased NT with Normal Chromosomes Increased Risk of Cardiac or Other Major ANATOMIC ANOMALIES Souka AJOG 2005 ; 192: 1005 30 / 45 > 6.5 20 / 25 5.5 – 6.4 7 / 20 4.5 – 5.4 3 / 10 3.5 – 4.4 1 / 1 2.5 – 3.4 % / % Cardiac / Other Major NT size mm

NUCHAL TRANSLUCENCY Why Measure It? Increases Sensitivity vs Maternal Analytes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

NUCHAL TRANSLUCENCY Why Measure It? ,[object Object],[object Object]

COMPLETE THE SCREENING ,[object Object],[object Object],[object Object]

NT MORE THAN 99 PERCENTILE 3.5 OR MORE FROM 45-84 MM

NT > 99 % tile @ 3.5 mm or more ,[object Object],[object Object],[object Object]

NT 3.5 mm or Greater Level 2 Sono and Fetal Echo Recommended by ACOG & CPSP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Souka AJOG 2005;192:1005-21 Kagan Obstet Gynecol 2006;107:6

CYSTIC HYGROMA 50% RISK OF ANEUPLOIDY

Other Sono Markers to evaluate T13 T 18 MEGACYSTIS 20% ANEUPLOIDY OMPHALOCELE 60% ANEUPLOIDY

First Trimester Serum Analytes ,[object Object],[object Object]

First Trimester Serum Analytes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

First Trimester Serum analytes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

First Trimester Serum Analytes ,[object Object],[object Object],[object Object],[object Object],[object Object]

Cnmnpcpsp

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