Increased fetal nuchal translucency at 11–14 weeks

Nicolaides, Kypros H.; Heath, V.; Cicero, S.

doi:10.1002/pd.308

Cited by 169 publications

(120 citation statements)

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“…TTTS characterized by overgrowth of a recipient twin and undergrowth of the donor twin is attributed to vascular communication via placenta between twins (Wee and Fisk 2002;Nicolaides 2002;Crombleholme 2003). Polycytemia and anemia seen in case 4 are an example of TTTS, and to our knowledge, only one case of MC DZT with TTTS other than case 4 has been reported in the literature (Quintero et al 2003).…”

Section: Clinical Implications Of MC Placentamentioning

confidence: 93%

Do monochorionic dizygotic twins increase after pregnancy by assisted reproductive technology?

Miura

Niikawa

2004

J Hum Genet

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Although monochorionic (MC) dizygotic twins (DZT) are extremely rare in natural pregnancy, six pairs of such twins have successively been reported in a recent short period. All six cases of MC DZT were the products of pregnancy by assisted reproductive technology (ART). In this overview, we summarize these six cases and discuss possible mechanisms of this twinning and clinical implications of confined blood cell chimerism (CBC). The placental MC membrane was diagnosed ultrasonographically in all cases and pathologically in four. The presence of CBC was confirmed in four cases by haplotyping at polymorphic marker loci in peripheral blood leukocytes, karyotyping of lymphocytes and skin fibroblasts, and/or ABO blood group typing. As CBC is attributable to placental vessel anastomosis between DZT, it may become a risk factor for twin-twin transfusion syndrome (TTTS), mortality, and for other complications in twins. MC DZT may produce psychological trauma, especially in a girl/woman when she grows up and is known to be chimeric for a male karyotype and vice versa, although genital organs are generally normal-unlike freemartin in cattle. In addition, CBC in twins may mislead physicians when genotyping for a disease-susceptibility test is performed in medical practice in the near future. Blood group chimera may also cause confusion if a blood transfusion is necessary. Therefore, sufficient informed consent prior to ART and genetic counseling before/after birth are absolutely necessary for improved quality of life. It is most likely that all six cases are the consequence of fusion between two outer cell masses from two zygotes. The ART used in the six MC DZT included in vitro fertilization-embryonic transfer (IVF-ET) into the uterus, FSH-induced superovulation followed by intrauterine insemination, and/or intracytoplasmic sperm injection (ICSI). The use of an ovulation-inducing agent and implantation of several fertilized eggs at close sites are probably the events common among these cases. Assisted hatching, simultaneous ET, the use of eggs that have developed to the blastcyst stage, and cell culture procedures that lead to changes of the nature of cell surface, all may increase the chance of a cell fusion. This ''chance hypothesis'' can simply explain why MC DZT are very rare in natural pregnancy. Large-scale research on the prevalence of ART-associated MC DZT and long-term follow-up of the twins are essential.

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Section: Clinical Implications Of MC Placentamentioning

confidence: 93%

Do monochorionic dizygotic twins increase after pregnancy by assisted reproductive technology?

Miura

Niikawa

2004

J Hum Genet

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“…The NTM screens for DS in the first trimester of pregnancy and is done by ultrasound scanning. 22 The MST is a blood test in the second trimester of pregnancy ("triple-test") and screens for DS and NTDs. 23 Both prenatal screening tests provide an individualized risk estimation of having a child with one of these disorders, and thus identify a high-risk subgroup within a population of pregnant women.…”

Section: Settingmentioning

confidence: 99%

Are pregnant women making informed choices about prenatal screening?

Berg

Timmermans

Kate

et al. 2005

Genetics in Medicine

169

141

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Purpose: Prenatal screening should enable pregnant women to make informed choices. An informed decision is defined as being based on sufficient, relevant information and consistent with the decision maker's values. This study aims to assess to what extent pregnant women make informed choices about prenatal screening, and to assess the psychological effects of informed decision-making. Methods: The study sample consisted of 1159 pregnant women who were offered the nuchal translucency measurement or the maternal serum screening test.Level of knowledge, value consistency, informed choice, decisional conflict, satisfaction with decision, and anxiety were measured using questionnaires. Results: Of the participants, 83% were classified as having sufficient knowledge about prenatal screening, 82% made a value-consistent decision to accept or decline prenatal screening, and 68% made an informed decision. Informed choice was associated with more satisfaction with the decision, less decisional conflict (this applied only to test acceptors), but was not associated with less anxiety. Conclusion:Although the rate of informed choice is relatively high, substantial percentages of women making uninformed choices due to insufficient knowledge, value inconsistency, or both, were found. Informed choice appeared to be psychologically beneficial. The present study underlines the importance of achieving informed choice in the context of prenatal screening. Genet Med 2005:7(5):332-338.

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“…16 Possible mechanisms for increased NT are: cardiac failure in association with the abnormalities of heart and great arteries, venous congestion in the head and neck due to various reasons, altered composition of the extracellular matrix, abnormal or delayed development of the lymphatic system and also failure of the lymphatic drainage, fetal anemia or hypoproteinemia, congenital infection of the fetus etc. 17 Whatever the etiologies for fetal nuchal translucency are, measurement of nuchal translucency as a screening method has firmly taken place in practice. Our study has shown that NT measurement is effective in picking up the most of the cases.…”

Section: Discussionmentioning

confidence: 99%