Correlation Between Sagittal and Transverse Plane Fetal Nuchal Translucency Measurement

Pananya Jomphansa; Suthasinee Metaneedol; Sinart  Prommas; Buppa Smanchat; Kornkarn Bhamarapravatana; Komsun Suwannarurk

doi:10.33192/smj.v77i2.271485

Authors

Pananya Jomphansa Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Thailand
Suthasinee Metaneedol Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Thailand
Sinart Prommas Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Thailand
Buppa Smanchat Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Thailand
Kornkarn Bhamarapravatana Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Komsun Suwannarurk Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand

DOI:

https://doi.org/10.33192/smj.v77i2.271485

Keywords:

Nuchal translucency, aneuploidy, pregnancy, transverse plane, ultrasound

Abstract

Objective: This study aimed to evaluate and compare nuchal translucency (NT) measurement between sagittal and transverse planes for aneuploidy screening.

Materials and Methods: This prospective study was conducted at the antenatal clinic, department of obstetrics and gynecology, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Bangkok, Thailand between November 2023 and July 2024. Subjects were singleton pregnant women who underwent fetal chromosome anomaly screening by NT measurement of both sagittal and transverse planes by transabdominal ultrasonography between 11 and 14 weeks of gestational age (GA). Demographic and clinical data were collected and evaluated. Relationship between sagittal and transverse planes measurement was analyzed.

Results: A total of 295 pregnant women were recruited. The mean age and GA of participants were 31.7 years old and 12.9 weeks, respectively. Prevalence of aneuploidy was 2.7 (8/295) percent. The mean NT measurement in the sagittal plane was significantly lower than in the transverse plane (1.5 and 1.7 mm). Transverse and sagittal plane measurement exhibited a linear correlation. The cut off point of NT by transverse and sagittal approach were 2.9 mm and 3.0 mm, respectively that giving comparable diagnostic value.

Conclusion: NT measurement cut off by transverse approach at 2.9 mm had comparable to 3.0 mm of sagittal approach.

References

Screening for Fetal Chromosomal Abnormalities: ACOG Practice Bulletin, Number 226. Obstet Gynecol 2020;136:48-69.

Kagan KO, Avgidou K, Molina FS, Gajewska K, Nicolaides KH. Relation between increased fetal nuchal translucency thickness and chromosomal defects. Obstet Gynecol. 2006;107:6-10.

Tubtimkhiao P, Orungrote N, Mungkorntongsakul S, Bhamarapravatana K, Suwannarurk K. The Correlation between Small Placental Volume Measured by Three-dimensional Ultrasonography and Adverse Pregnancy Outcomes: An Observational Study. Siriraj Med J. 2024;76(9):595-603.

Ounphamornlah N, Luangdansakul W, Orungrote N, Pleankong M, Petcharat K, metaneedol S, et al. Prevalence of Abnormal Cerebroplacental Ratio in Uncomplicated Full-term Pregnancy and Correlation with Adverse Perinatal Outcomes. Siriraj Med J. 2024;76(8):514-21.

Ruangvutilert P, Rekhawasin T, Phatihattakorn C, Boriboonhirunsarn D. Accuracy of Third Trimester Ultrasound for Predicting Large-for-Gestational Age Newborn in Women with Gestational Diabetes Mellitus. Siriraj Med J. 2021;73(5):322-9.

Jaisaby A, Phaliwong P, Prommart S, Smanchat B, Bhamarapravatana K, Suwannarurk K. The Accuracy of Cervical Length for Prediction of Delivery in Term Pregnancy Patients Presenting with Labor Pain. Siriraj Med J. 2019;71(4):278-83.

Dinç G, Eyüboğlu İ. Distribution of nuchal translucency thickness at 11 to 14 weeks of gestation in a normal Turkish population. Turk J Med Sci. 2021;51:90-4.

Cunningham FG, Leveno KJ. Obstetrical imaging. In: Cunningham FG, Leveno KJ, editors. Williams obstetrics. 26th ed. New York: McGraw Hill Education; 2026.p.248-50.

Liao Y, Wen H, Ouyang S, Yuan Y, Bi J, Guan Y, et al. Routine first-trimester ultrasound screening using a standardized anatomical protocol. Am J Obstet Gynecol. 2021;224:396.e1-15

Kor-Anantakul O, Suntharasaj T, Suwanrath C, Chanprapaph P, Sirichotiyakul S, Ratanasiri T, et al. Distribution of normal nuchal translucency thickness: a multicenter study in Thailand. Gynecol Obstet Invest. 2011;71(2):124-8.

Suntharasaj T, Ratanasiri T, Chanprapaph P, Kengpol C, Kor-anantakul O, Leetanaporn R, et al. Variability of nuchal translucency measurement: a multicenter study in Thailand. Gynecol Obstet Invest. 2005;60:201-5.

Montaguti E, Diglio J, Petrachi B, Arosio V, Fiorentini M, Cavalera M, et al. Identification of Fetuses at Increased Risk of Trisomies in the First Trimester Using Axial Planes. Fetal Diagn Ther. 2024;51:1-6.

Montaguti E, Rizzo R, Diglio J, Di Donna G, Brunelli E, Cofano M, et al. Increased nuchal translucency can be ascertained using transverse planes. Am J Obstet Gynecol. 2022;227(5):750.e1-6.

Bilardo CM, Chaoui R, Hyett JA, Kagan KO, Karim JN, Papageorghiou AT, et al. ISUOG Practice Guidelines (updated): performance of 11-14-week ultrasound scan. Ultrasound Obstet Gynecol. 2023;61:127-43.

Malinger G, Paladini D, Haratz KK, Monteagudo A, Pilu GL, Timor-Tritsch IE. ISUOG Practice Guidelines (updated): sonographic examination of the fetal central nervous system. Part 1: performance of screening examination and indications for targeted neurosonography. Ultrasound Obstet Gynecol. 2020;56:476-84.

Paladini D, Malinger G, Birnbaum R, Monteagudo A, Pilu G, Salomon LJ, et al. ISUOG Practice Guidelines (updated): sonographic examination of the fetal central nervous system. Part 2: performance of targeted neurosonography. Ultrasound Obstet Gynecol. 2021;57:661-71.

Pinnington TR, Arthan J, Komoltri C, Chanprapaph P. Accuracy of the Combined First Trimester Down Syndrome Screening Test and the Optimum Range of the Cut-off Point for Intermediate-Risk Identification: Twelve years’ Experience. Thai J Obstet Gynaecol. 2024;32:269-77.

Tomai XH, Schaaps JP, Foidart JM. Fetal nuchal translucency thickness in different cut-off points for aneuploidy screening in the south of Vietnam. J Obstet Gynaecol. 2011;37:1327-34.

Yin D, Chen L, Wang L, Zeng Y, Tang F, Wang J. Does isolated nuchal translucency from 2.5 to 2.9 mm increase the risk of fetal chromosome disease. Mol Genet Genomics. 2022;297:1643-8.

Khalifeh A, Weiner S, Berghella V, Scott S, Gerson A. Comparative Analysis of Two- Versus Three-Dimensional Sonography for Nuchal Translucency Measurement. Am J Perinatol. 2016;33:486-9.

Karki S, Joshi KS, Tamrakar SR, Regmi S, Khanal K. Nuchal translucency in normal fetus and its variation with increasing crown rump length (CRL) and gestational age. Kathmandu Univ Med J (KUMJ). 2013;11(44):282-6.

Grossman TB, Bodenlos KL, Chasen ST. Abnormal nuchal translucency: residual risk with normal cell-free DNA screening. J Matern Fetal Neonatal Med. 2020;33:3062-7.