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Your First Trimester Scan or Nuchal Translucency Scan

December 3, 2020

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1. When?

This scan is carried out between the 11 weeks and 13 weeks-and-six-days marks.

2. How?

This scan is usually performed trans abdominally but select cases may warrant a transvaginal examination.

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 3. Why?

  • To Date the Pregnancy Accurately

This is particularly relevant for women who cannot recall the date of their last period, have an irregular menstrual cycle or have conceived whilst breastfeeding or soon after stopping the pill. Through this scan, we measure the size of the foetus and accordingly calculate the expected date of delivery.

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  • To Assess the Risks of Down's Syndrome and Other Chromosomal Abnormalities

The nuchal translucency scan forms the foundation for your personalised risk score. Typically, the inherent risk tethered to your pregnancy can be quantified by this scan. The score is a product of several factors: your age, the density of specific hormones in your bloodstream, the volume of fluid that cushions your baby’s back, your baby’s nasal bone structure, the blood flow to your baby’s heart and finally, foetal abnormalities. Before you venture further into your pregnancy, a counsellor on Cloudnine will walk you through the significance of various risks and possible options for further testing.

Approximately 2% of natural conceptions and 10% of assisted conceptions result in a higher-order pregnancy. In such a case, ultrasound scanning can determine if the babies are developing normally. The scan can also gauge whether the babies share the same placenta, which can potentially lead to problems in the pregnancy. The Twin Clinic on Cloudnine is tailored to handle multiple gestations, where every higher-order pregnancy is monitored closely.

  • To Diagnose Certain Major Foetal Abnormalities

Major abnormalities may be visible at this early stage, but another detailed anomaly scan is essential at the 19-week mark.

  • To Diagnose Early Pregnancy Failure

Unfortunately, 2% of women who attend the nuchal scan are found to have had an early pregnancy failure, where the foetus has died often several weeks before, without any warning. On Cloudnine, we envelope couples who have miscarried in comfort and care through counselling sessions that delve into the possible causes of the miscarriage. These sessions also touch upon subsequent measures that may be necessary to achieve a full-term pregnancy.

  • To Assess the Risk of Potential Growth Problems in the Foetus

The nuchal translucency scan sheds light on possible growth limitations.

  • To Assess the Risk of Future Maternal Complications Like Pre-Eclampsia

The nuchal translucency scan provides a keyhole to impending maternal complications for an expectant mother, allowing doctors to forge a medical plan in accordance with potential health risks.

Your Personalized Risk of Carrying a Baby with Down's Syndrome

The vast majority of babies are normal. However, all women regardless of age, carry a small risk up to 2%, of delivering a baby with a physical handicap, mental handicap or both. Some handicap cases are caused by chromosomal abnormalities such as Down's Syndrome, which is triggered by the presence of an extra chromosome in foetal cells (Trisomy 21).  Other chromosomal abnormalities like Trisomy 13 and Trisomy 18 can also be detected by this test.

Indicators of chromosomal abnormalities in a foetus include:

  • Age of the mother
  • Amount of fluid that cushions the neck of the foetus (nuchal translucency)
  • Presence or absence of the foetal nasal bone
  • Foetal heart rate
  • Blood flow through the tricuspid valve of the foetal heart
  • Blood flow through the ductus venosus in the foetal liver
  • Presence or absence of any physical abnormalities
  • Level of two hormones (free ß- HCG and PAPP-A) in the expectant mother's blood.

The estimated risk of Down’s Syndrome in your baby is calculated based on all the aforementioned factors. Following the scan, your obstetrician may discuss possible risks with you.It is recommended that you have another scan, called the foetal anomaly scan, at 19 weeks to check for foetal malformations, abnormal developments and birth defects in your baby.  On Cloudnine, our seasoned sonographers, obstetricians and radiologists are armed with state-of-the-art software that assures accuracy and precision for this scan.


  • What Next?


1. A Discussion on the Way Around

Once your personalised risk score has been calculated, your obstetrician will discuss the result with you. If you are at High Risk, then you and your partner may be advised two further definitive diagnostic tests: amniocentesis and chorionic villous sampling. These tests are also called invasive tests because they extract a sample from the pregnancy to analyse the chromosomal construct of the foetus.

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Know more- Pregnancy Care Advice for your First Trimester.

2. Consideration Based on Risk

These tests are the only way to know for sure whether the foetus has a chromosomal abnormality. However, these tests carry a risk of a miscarriage of about 3 in 1000 cases even if the test is performed by a qualified and experienced foetal medicine specialist. It is up to you and your partner to decide whether the risk of the foetus hosting a chromosomal abnormality is high enough to warrant performing an invasive test. As a guideline, an invasive test is usually offered if the risk of Down's Syndrome is 1 in 250 or above.

Who Performs These Further Diagnostic Tests?

These tests are carried out by experienced specialists in foetal medicine, who are continually guided by the beats on an ultrasound. The tests are performed in an aseptic environment.

What are the Amniocentesis and Chorionic Villous Sampling Tests?

Chorionic villous sampling is a test in which a small sample of placental tissue is removed via a needle passed through an expectant mother’s abdomen. This can be performed between the 11th and 15th week of pregnancy.

Watch Video on 3D and 4D Ultra Scan:

Amniocentesis is a test in which the fluid surrounding the foetus is sampled via a needle passed through an expectant mother’s abdomen.  This test should only be performed after the 15th week of gestation.

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What Other Information Does the First Trimester Scan Provide?

  • Foetal Anatomy

The first-trimester scan reviews foetal development to rule out any major foetal anomalies or birth defects. The intracranial translucency and other aspects of the foetal brain are observed for signs of open spina bifida. The four foetal limbs and major organs are also examined. Another scan at 19 weeks will delve further into the condition of the foetal spine, heart and face.

  • Prediction of Foetal Growth Restriction and Maternal Pre-Eclampsia

The assessment of the uterine artery doppler can be a valuable tool in assessing the risk of foetal growth restriction and maternal preeclampsia. If the risk is found to be high, a low dosage of aspirin can be started at an early stage, which can reduce the risk of these complications during pregnancy.

Our customers had a few questions regarding this blog, check them out now!

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