{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T17:51:02Z","timestamp":1770918662647,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T00:00:00Z","timestamp":1633651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>In this era of non\u2010invasive\u2010prenatal testing (NIPT), when dating scans are usually performed around 10\u00a0weeks of gestation, an increased NT before the official established timeframe (CRL between 45 and 84\u00a0mm) may be encountered. Information on management of these pregnancies is limited. Therefore, we evaluated the relationship between an early increased NT and adverse pregnancy outcome. Secondary, we evaluated the rate of chromosomal anomalies that might have been missed in first trimester should solely NIPT be performed as first\u2010tier test, and the rate of adverse pregnancy outcome if NT normalizes before 14\u00a0weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective cohort study that included all pregnancies between January 1, 2007 and June 1, 2020 in Amsterdam UMC locations AMC and VUmc. We included fetuses with a crown\u2010rump length (CRL)\u00a0&lt;\u00a045\u00a0mm (\u223c11\u00a0weeks) and a nuchal translucency (NT) measurement \u22652.5\u00a0mm. Fetuses referred with an early increased NT and a major fetal anomaly at the dating scan were excluded, as were cases of parents with a family history of monogenetic disease(s) or recognized carriers of a balanced translocation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 120 fetuses of which 66.7% (80\/120) had an adverse pregnancy outcome. Congenital anomalies were present in 56.7% (68\/120), 45.8% (55\/120) had a chromosomal anomaly. The prevalence of congenital anomalies was 30.3% in fetuses with NT 2.5\u20133.4\u00a0mm compared to 66.7% with NT\u00a0\u2265\u00a03.5\u00a0mm (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). 16.7% (20\/120) had a chromosomal anomaly that might have been missed by conventional NIPT in first trimester. We found an adverse pregnancy outcome of 24% in the group with a normalized NT compared to 78.1% in the group with a persistently increased NT (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An early increased NT should make the sonographer alert. In this selected cohort, an early increased NT was associated with a high probability of having an adverse pregnancy outcome. Regardless of CRL, we deem that an early increased NT\u00a0\u2265\u00a03.5\u00a0mm warrants referral to a Fetal Medicine Unit for an extensive work\u2010up. NT normalization seems favorable, but a prospective study should define the appropriate work\u2010up for NT in the lower range (2.5\u20133.4\u00a0mm).<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6054","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T18:37:21Z","timestamp":1633027041000},"page":"1685-1693","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Increased nuchal translucency before 11\u00a0weeks of gestation: Reason for referral?"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8385-2150","authenticated-orcid":false,"given":"Malou A.","family":"Lugthart","sequence":"first","affiliation":[{"name":"Department of Obstetrics Amsterdam Reproduction and Development Research Institute Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo B.","family":"Bet","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Amsterdam Reproduction and Development Research Institute Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fleur","family":"Elsman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Amsterdam Reproduction and Development Research Institute Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karline","family":"van de Kamp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Amsterdam Reproduction and Development Research Institute Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernadette S.","family":"de Bakker","sequence":"additional","affiliation":[{"name":"Department of Medical Biology Section Clinical Anatomy\u00a0&amp; Embryology Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingeborg H.","family":"Linskens","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Amsterdam UMC Vrije Universiteit Amsterdam  Amsterdam The\u00a0Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merel C.","family":"van Maarle","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"van Leeuwen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Amsterdam Reproduction and Development Research Institute Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Pajkrt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Amsterdam Reproduction and Development Research Institute Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)11280-6"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5299"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000191301.63871.c6"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.304.6831.867"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1998.11060401.x"},{"key":"e_1_2_9_7_1","first-page":"1","article-title":"Impact of increased nuchal translucency values on pregnancy outcomes: 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