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Nuchal Translucency Ultrasound
Staring at the deep magenta spot on my pregnancy testing stick, my first thought was, ‘Pregnant at 41 is very unlike pregnant at 32.’
Just behind the doctor’s head, about level with her ear, was a tatty little chart of statistical probabilities of Down’s Syndrome births in relation to increasing maternal age. You couldn’t miss it. Mine had gone up to 1 in 42. At first I thought I would cut out all the agonising and go straight to amniocentesis, an invasive diagnostic test offered routinely to mothers over 35. This test diagnoses Down’s Syndrome but has a 1 in 100 risk of miscarriage. Then I heard through friends about Professor Nicolaides at Kings College Hospital, Dulwich, and an ultrasound screening test called Nuchal Translucency or Nuchal Fold. The test is carried out between 11 and 13 weeks from the date of the last menstrual period (LMP). The ultrasound measures at the back of the foetus’s neck, an area that appears as a black stripe down its back.
This is strictly a screening test. It gives no concrete answers, only statistics. A combination of measuring the nuchal fold and the mother’s age will give a new statistical probability about the possibility of Down Syndrome or other chromosomal abnormalities. Nicolaides had found that 18% of foetuses with nuchal folds above 3mm had Down’s Syndrome. The risk rose with the thickening of the fold – a measurement of 6mm meant 36 times the base risk. So, the overall risk for Down’s Syndrome at 35 is around 1 in 270. If the foetus has a nuchal fold of 6mm, then its risk becomes 1 in 7.5.
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