Key result
Pregnant individuals with increased nuchal translucency but without a positive NIPT for aneuploidy were at a significantly higher risk for delayed termination of pregnancy at ≥15 weeks (p=0.004).
Why the study?
Termination of pregnancy after increased nuchal translucency is common, but characteristics distinguishing individuals undergoing termination at or after 15 weeks versus before 15 weeks needed identification.
What are the risk factors for delayed termination of pregnancy (≥15 weeks) following increased nuchal translucency?
Cohort (n=689)
No
What are the risk factors for delayed termination of pregnancy (≥15 weeks) following increased nuchal translucency?
Absence of positive NIPT for aneuploidy and the need for additional imaging are significant risk factors for delayed termination of pregnancy (≥15 weeks) in cases of increased nuchal translucency.
May inform risk stratification for late termination in increased NT without positive NIPT; leaves open prospective validation before practice change.
OBJECTIVES: Termination of pregnancy after increased nuchal translucency (NT) is a common occurrence. This study aimed to identify characteristics of a cohort with a NT ≥3.0 mm who underwent a pregnancy termination ≥15 weeks compared with those who terminated <15 weeks. METHODS: All NT ≥3.0 mm identified within our department over an 11-year period (2010-2021) (n = 689) were retrospectively examined and characteristics of the cohort of increased NTs ending in termination were further categorized. RESULTS: There were 221 (32.1%) individuals with an increased NT (≥3 mm) who underwent a termination of pregnancy within our study period (2010-2021). Pregnancy termination occurred at a gestational age <15 weeks in 162 (73.3%) and ≥15 weeks in 59 individuals. Pregnant individuals without positive NIPT for aneuploidy were at a higher risk for a ≥15-week termination (p = 0.004). In 29% (17/59) of late terminations, there were additional imaging findings after the NT scan (ultrasound, echocardiogram, magnetic resonance imaging) that ultimately triggered the decision to pursue termination. CONCLUSIONS: As the options for workup of an increased NT expand, potential delays in decision-making surrounding termination increase. This study identifies multiple reasons for delayed termination and proposes several approaches to care aimed at maximizing diagnostic information by imaging and diagnostic testing in an expedited manner.
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Bunnell et al. (2023) conducted a cohort in Increased nuchal translucency (n=689). Absence of positive NIPT for aneuploidy vs. Positive NIPT for aneuploidy was evaluated on Termination of pregnancy at ≥15 weeks (p=0.004). Pregnant individuals with increased nuchal translucency but without a positive NIPT for aneuploidy were at a significantly higher risk for delayed termination of pregnancy at ≥15 weeks (p=0.004).
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