Nuchal Fold Or Nuchal Translucency: Measures, Causes, Malformations And Everything

The nuchal translucency test is an ultrasound analysis that consists of measuring the nuchal fold of the fetus. The region of the baby’s neck is known as the nuchal fold in which fluid accumulates during the gestational period, however this is transitory and transient. The study is carried out in the fetus from the ninth week of gestation to achieve, although for greater reliability it is carried out between weeks 10 and 14.

To carry out a correct measurement, the specialist in charge must make sure that the baby is placed on its side, because that is how the longitudinal cut can be seen. Once the baby is in the correct position, the specialist should begin to measure everything that includes the maximum thickness of the subcutaneous translucency, this is located between the skin and the soft tissue, the latter is the one that covers the cervical spine.

If an increase in the thickness of the nuchal translucency is perceived, exceeding 3 mm, this may be associated with the possible existence of a chromosomal abnormality. In such a case that there is an excessive accumulation of fluid, this can be related to Trisomy 21, which is what is known as the main cause of Down Syndrome.

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What do we call the nuchal fold?

The region that is located on the back of the fetus’s neck is known as the nuchal fold and a little fluid accumulates there, either in a physiological or natural way. When the fetus is between 10 and 14 weeks, an ultrasound study called Nuchal Translucency can be performed, which will allow detecting in time and ruling out any suspicion of Trisomy 21 or Down Syndrome as it is better known.

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Absence of nasal bone

The nasal bone is another important indicator when the nasal bone is absent, as it is a characteristic of children who have the condition of Down syndrome, they usually have a very small nose and the base is sunken. From week 11 these can be detected in the embryo, in which the absence of the nasal bone or, failing that, its poor development will be noted.

However, in children from mothers who are Caucasian, it can also have these characteristics.

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Causes of increased nuchal fold

The main cause of the increased nuchal fold is due to an alteration in the chromosome, generally it has to do with the trisomy of the 21st pair that gives rise to Down syndrome or the 13th trisomy, the latter has to do with the Patau syndrome . Both syndromes cause physical and mental changes in the individual.

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When is the nuchal fold done?

The ideal time to perform the examination of the nuchal fold is between weeks 11 and 14, in this period the base of the baby’s skull is still transparent. As the baby increases its growth, this nuchal fold loses its transparency, making it very difficult to carry out the study after the indicated time.

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Does the nuchal fold grow as the baby grows? Why?

The nuchal fold is called the posterior area that is located in the neck of the fetus and this area usually accumulates fluid in a transitory way, however it is important that this fluid be measured between weeks 11 and 14 to rule out that there is a chromosomal alteration.

Like the whole body, the nuchal fold develops with the growth of the baby and the accumulated fluid is adjusted until it reaches the most ideal. At the end of this article you will find a table in which you will find the normal measurements and parameters of this nuchal fold that fits the size of the baby.

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Can the nuchal fold decrease? Why?

The baby’s nuchal fold does not decrease as such, the fluid that is accumulated in it spreads as the baby grows and this is what will cause the size to change. It is important to bear in mind that the accumulation of fluid may be normal or if it is excessive, it may indicate that there is a chromosomal abnormality.

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Nuchal fold measurements and parameters, how much is normal?

It is understood as normal values ​​when the nuchal translucency is less than 3mm, since in most cases there is nothing to worry about. It is considered among the normal parameters that a fetus at 11 weeks has a measurement of 2 mm and that at 13 weeks with 6 days it is located up to 2.8 mm.

It has been scientifically proven that when an amount of fluid is perceived in the nuchal fold greater than 3 mm, there may be a genetic malformation. In addition, it is said that the risk increases as the thickness of the nuchal translucency increases, making it known that there is a risk of 10% if the thickness is between 3-4 mm, the risk is 40% if the measure is located between 4-6 mm, and the risk increases to 80% if the thickness is greater than 6mm.

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During pregnancy, how does the nuchal fold evolve?

First term

When there is an increase in the nuchal fold during the first trimester, it is an indication that something is wrong, Down syndrome being one of the most common. When there is an increased translucency above the 95th percentile and it does not matter if the fluid is in the neck or if it surrounds the fetus, it still means that there is an alteration in the chromosome.

second trimester

During the second trimester of the gestational period, nuchal translucency generally decreases; its disappearance is considered to be related to changes in risk mentioned above.

Third quarter

The third trimester of pregnancy is one of the most anxious for the mother, since the baby is about to be born, and by this time the mother must be aware if her baby has any chromosomal alteration thanks to all the studies that previously it should have been done.

However, in such a case that the mother has not controlled the pregnancy in the correct way then she will be on the lookout for everything. Well, the study to determine that there is an increased nuchal fold can only be carried out between week 11 and week 14.

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Low nuchal crease and Down syndrome

The nuchal translucency study in the fetus carried out between weeks 11 and 14 is decisive to verify or rule out the existence of trisomy of pair 21 or pair 13. If the accumulated fluid causes the nuchal fold to be greater than 3 mm Down syndrome is very likely.

Now, if the nuchal fold is low, it is not ruled out that there is no possibility that the fetus may have the condition, as there are other characteristics that can show that there is a chromosomal abnormality of pair 21, and one of them is the absence of the nasal bone or its diminished development.

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The nuchal fold and heart disease

The measurement of the nuchal fold is a study that should be carried out between weeks 11 and 14 to rule out that there is an anomaly such as trisomy of pair 21 and pair 13, although not in all cases it is always about them, since in some Sometimes it can also refer to congenital heart disease, however this symptom is not entirely reliable in these cases, it is simply an associated relationship that occurs in some cases.

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What are the malformations?

With the study of nuchal translucency, it is not only possible to rule out or verify if there is any chromosomal abnormality through the measurement of the nuchal fold. Major fetal abnormalities can also be diagnosed. In general terms, the following aspects can be visualized through the echo: visualize the contour of the skull, evaluate the cerebrospinal fluid that circulates between the cerebral ventricles; It is also possible to see the profile of the face, the eyeballs, the maxilla and the upper lip.

In the same way, you can visualize the lungs, diaphragmatic domes, cardiac orientation, abdominal formation (stomach, intestines, kidneys, bladder, renal arteries, insertion of the umbilical cord), the spine. Finally, observe the formation of the limbs.

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What happens during a twin pregnancy?

During a twin pregnancy, the nuchal translucency study is extremely important, since through it the combined Down syndrome screening can be performed. With the study, the corresponding measurement of each fetus can be made and verify that there is no possible condition.

Now, if the twin gestation develops in a single placenta (monochorial gestation), the measurement can be performed and the average of both nuchal translucencies can be taken, while if it develops in two placentas (bicorial gestation) the individual measurement of each fold.

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Nuchal translucency, what does it detect?

Through the nuchal translucency study, it is possible to detect if the fetus has any chromosomal abnormality, such as trisomy 21, which is the cause of Down syndrome. For this, the measurement of the nuchal fold is carried out in conjunction with biochemical parameters of the maternal serum.

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Risks that are run with nuchal translucency, why?

There are no risks with this study if it is carried out within the established time, unlike other studies this is non-invasive and there is no possibility that the mother suffers a spontaneous abortion.

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Table of normal values ​​of nuchal translucency





Normal karyotype Healthy newborn
Fetal death Major fetal abnormalities
<95th percentile 0.2% 1.3% 1.6% 97%
95th – 99th percentiles 3.7% 1.3% 2.5% 93%
3.5 – 4.4 mm 21.1% 2.7% 10.0% 70%
4.5 – 5.4 mm 33.3% 3.4% 18.5% fifty %
5.5 – 6.4 mm 50.5% 10.1% 24.2% 30%
≥ 6.5 mm 64.5% 19.0% 46.2% fifteen %
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Kathie Sand always saw the world of beauty as the terrain on which to build her professional career, a goal that was clear to her when she was only 15 years old. Her great concern to expand knowledge led her to settle in Paris where she studied hand in hand with the best beauty professionals and with the most advanced techniques for skin care.

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