الفهرس 
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Abstract
The purpose of this study was to assess the clinical effectiveness of using fetal NT during gestational weeks 10 to 13 weeks for screening the congenital fetal malformation .
Fifty pregnant women (in the first trimester 10-13 weeks) were included in this study during the period between March 2015 to December 2015.
In our study we found that most risk factors for increase fetal NT were increase maternal age over 35 years and presence history of Down syndrome.
In our study we found that the rate of IUFD was increased with fetuses having positive NT than the cases having normal fetal NT.
As regards outcome with increased fetal NT, there are about 84.6% having abnormal outcome (associated congenital anomalies)
As regards outcome with history of Down syndrome, there are about 92.3% having abnormal outcome.
Out of fifty pregnant women screened, only 20 women were found have increased fetal NT. These cases were subjected for further follow up at the second trimester of pregnancy.
In our study we found that there are multiple associated congenital anomalies with increased fetal NT. The most common congenital anomalies diagnosed were the facial anomalies as nasal bone defect (30%), maxilla anomalies (15%), low set ear (20%) and retrognathia (15%). The second most common anomalies were cardiac anomalies (15%), other associated less common anomalies are soft tissue edema (10%), Hydrops fetalis(5%) and lower limb anomalies (5%).
In this study, it was evident that NT shows good sensitivity, specificity, PPV and NPV with accuracy about 86.2%. And it was evident that history of Down syndrome has accuracy about 89.7 %.
In this study, we found that there are multiple factors that interfere with measuring of NT by 2D US (30%), however; all of cases measured by 4D US .With no statistical significant difference at measurement of NT by 2 methods with experienced operator.
In conclusion, This study has shown the feasibility of implementation of nuchal translucency screening program with little changes in routine practice and with only minimal additional resources, One of the common criticisms of routine nuchal translucency screening is that additional time for booking scans and specially trained staff is required in order to achieve satisfactory results.
Also, this study highlights the value of first trimester NT screening as well as the necessity for focused fetal assessment and infant follow up in cases with increased NT.
For optimal early screening, the patient should be referred for an ultrasound scan at around 15or 16 weeks of amenorrhea in cases of NT thickness exceeding a defined threshold. If CHD is suspected, the patient can be referred to a pediatric cardiologist for echocardiography during the second trimester to confirm the diagnosis and to establish the possible most accurate prognosis.