The 11–14 week scan

Fetal nuchal translucency thickness (NT) at the 11–14 week scan has been combined with maternal age to provide an effective method of screening for trisomy 21; for an invasive testing rate of 5%, about 75% of trisomic pregnancies can be identified. When maternal serum free-β-human chorionic gonadotropin and pregnancy-associated plasma protein-A at 11–14 weeks are also taken into account, the detection rate of chromosomal defects is about 90%. Increased NT can also identify a high proportion of other chromosomal abnormalities and is associated with major defects of the heart and great arteries, and a wide range of skeletal dysplasias and genetic syndromes. Other benefits of the 11–14 week scan include early diagnosis of major fetal defects and the detection of multiple pregnancies, as well as reliable identification of chorionicity. As with the introduction of any new technology into routine clinical practice, it is essential that those undertaking the 11–14 week scan are adequately trained and that their results are subjected to rigorous audit.