Neck fold measurement: everything about the procedure and costs

What is the nuchal fold measurement (nuchal translucency measurement)?

Nuchal translucency is a liquid gap in the neck area that can be visualized on ultrasound in almost every child between the ages of 11 and 14 weeks. The nuchal translucency measurement, also known as the nuchal fold measurement, is part of the first trimester screening, which is carried out between the 12th and 14th week. The skin on your baby’s neck is measured using ultrasound. If it is greatly enlarged, this can indicate a chromosomal abnormality. As part of the screening, the measured value is used to determine a statistical probability that your baby could have a chromosomal anomaly. Your doctor can use this test to find indications of the presence of Down syndrome or Edwards syndrome, but also of other diseases. The nuchal translucency measurement primarily gives expectant mothers information about

Nuchal translucency shows fluid accumulation

Between the 11th and 14th week of pregnancy, your baby’s lymphatic system and kidneys are developing. During this period, the liquid cannot be drained. Lymph accumulation occurs. The nuchal translucency develops during the accumulation of fluid. Liquids appear black on standard ultrasound monitors because they are anechoic. The nuchal translucency measurement also owes its name to this fact. The liquid on the ultrasound images is transparent.

Performing the nuchal translucency measurement

The nuchal translucency measurement is carried out between the 12th and 14th week of pregnancy. Unfortunately, the period of time for this examination is very short, since the lymphatic fluid in the folds of the neck of your baby can only be clearly seen in this short time. An ultrasound examination is usually sufficient to get a result. However, sometimes it is necessary to have a vaginal ultrasound, depending on the position of your baby. Your child will first be measured during the examination to find out in which week of pregnancy you are (more on this under “ Ultrasound examinations“). When measuring nuchal translucency, the maximum diameter of the area between the skin and soft tissue is determined over the cervical spine. This zone appears as a black gap on the ultrasound machine. Normal nuchal translucency is less than 2.5 millimeters, depending on the week of pregnancy. In order to be able to calculate exactly how pregnant the mother is, the child is measured again from head to toe to the lower end of the spine before the doctor determines the width of the nuchal translucency. Because the skin appears on the screen as a white “line” and the liquid beneath the skin appears black, one can see the head, spine, limbs, hands, and feet. Serious malformations could already be ruled out. Still should be in the 20th weekA detailed ultrasound examination should be carried out again.

Evaluation of the nuchal translucency measurement

During the examination, the nuchal translucency value is measured. With normal values, this is up to 2.0 millimeters at the beginning of the 12th week of pregnancy and up to 2.8 millimeters at 13 weeks and six days. The nuchal translucency increases with the baby. There is an increased risk with a nuchal translucency value of 2.9 millimeters. But don’t worry, it doesn’t necessarily have to be a health problem. Only a nuchal translucency value of over 6 millimeters is classified as questionable. But such high values ​​are rare.

What does a larger neck fold indicate?

If your baby’s neck fold is significantly larger, this can indicate a chromosomal disorder, but it doesn’t have to be. Your doctor therefore does not rely solely on these values. As part of the first trimester screening, he combines them with further information about your age, other characteristics of the child and the results of a blood test. From this information, he determines the probability that your child has a chromosomal disorder. The more information he can include, the more meaningful the result. You can read more about the calculation of the risk factor and the significance of the results in the article on “ first trimester screening ”.

Reliability of nuchal translucency measurement

• Unfortunately, the reliability of a nuchal translucency measurement is heavily dependent on how carefully your doctor proceeds. In order to be able to use the database for risk calculation, your gynecologist even needs a specific certificate from the “Fetal Medicine Foundation”, which must be renewed annually.
• In addition, to ensure that the nuchal translucency measurement is used correctly, the ultrasound machine should not be more than four years old and should have a metric scale that measures in increments of less than one millimeter.
• There were also study results regarding the reliability of the nuchal translucency measurement and the extended first trimester screening. A total of 100,000 pregnancies that were screened were studied. The result spoke for itself. 75 percent of the babies with Down syndrome could be identified. If the procedure was combined with other data and the results of a blood test as part of the first trimester screening, the chances of the doctor making the correct diagnosis even increased to 90 percent.

Screening test does not give 100% certainty

However, even if a lot of data is included, it is ultimately a pure screening test and does not provide a clear diagnostic statement. The result therefore does not offer 100% certainty. To be on the safe side, you can still have the so-called organ screening carried out even if there are no abnormal findings in the 20th week of pregnancy. If both the first trimester screening and the organ screening are unremarkable, you can look forward to the birth with great peace of mind.

Conspicuous nuchal translucency measurement, what now?

If you have been found to have an increased risk factor, your pregnancy will be classified as a “high-risk pregnancy”. But don’t worry, that doesn’t always mean that your child suffers from a chromosomal abnormality. To be sure, you can have further invasive diagnostic tests carried out. This will usually be an amniotic fluid test (amniocentesis). Alternatively, your doctor may prescribe a chorionic villus biopsy (CVS) or umbilical cord biopsyrecommend. All three methods are diagnostic tests. They are therefore more reliable than the nuchal translucency measurement. Your gynecologist will give you detailed advice in this situation and help you make a decision. Of course, whether you decide on one of the measures also depends on whether the result is important to you and whether it is relevant for the continuation of the pregnancy.

Coverage only if medically necessary

Nuchal translucency testing is an optional test, meaning it is not a preventive measure suggested by maternity guidelines. You must therefore bear the costs yourself. Here you can find more information about the costs of the neck fold measurement .