Risk factors for delayed termination of pregnancy following increased nuchal translucency

Abstract

AbstractObjectivesTermination 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.MethodsAll 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.ResultsThere 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.ConclusionsAs 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.