US Soft Markers

Question 1

What is the nuchal area & when can it be measured

Answer 1

Fluid filled area at back of neck, first & second trimester

Question 2

When is the nuchal translucency measured

Answer 2

11-13w6d

Question 3

What is an increased nuchal translucency associated with

Answer 3

Cardiac anomalies, trisomy 21 & monosomy x, also trisomy 13 & 18

Question 4

What is considered an abnormal nuchal translucency measurement between 11-13w6d

Answer 4

3 mm & greater

Question 5

When is the nuchal fold measured & what is considered an abnormal measurement

Answer 5

14-21 weeks, 6 mm or greater

Question 6

What is cystic hygroma associated with

Answer 6

Aneuploidy, (70-80% 45x), cardiac anomalies

Question 7

What is a choroid plexus cyst & what is it associated with

Answer 7

Small fluid filled bubble in the part of the brain that makes CSF, most resolve by 26w, no increased risk is isolated but if found with others associated with t18

Question 8

What is a single umbilical artery associated with

Answer 8

Aneuploidy (1% risk, 25% if not isolated), heart or renal anomalies

Question 9

What is an echogenic cardiac focus & what is it associated with

Answer 9

Bright spot in heart, trisomy 21 - is not useful in low risk pregnancies for aneuploidy risk

Question 10

What causes urinary tract dilation, & what fetal sex is it more common in

Answer 10

Urinary tract obstruction or urinary reflux, 2:1 males to females

Question 11

What is an echogenic bowel & what is it associated with

Answer 11

Bright spot in bowel, anueploidy, GI malformations, CF (4% chance ), viral infections, fetal bleeding, IUFD

Question 12

When can the nasal bone be measured & what is an absent or hypoplastic nasal bone associated with

Answer 12

Can only be present/absent in first, measure in second, most commonly associated with t21, also t13, t18, 45x

Question 13

When can shortened long bones be measured best, & what is the cutoff for O:E

Answer 13

16-20 weeks, femur <=91%, humerus (more reliable) <=90%

Question 14

What are shortened long bones associated with

Answer 14

T21, skeletal dysplasia, IUGR

Question 15

What is ventriculomegaly & what is it associated with

Answer 15

Increased abnormal CSF in ventricles, 33-60% with associated anomalies, 4% have aneuploidy when isolated, also NTDS, infections, tumors

Question 16

How do you adjust risk based on soft marker findings

Answer 16

Prior risk x LR = adjusted risk

Question 17

What are the ranges for mild, moderate, & severe ventriculomegaly

Answer 17

Mild:10-12 mm, moderate: 12-15 mm, severe: greater than 15 mm

Question 18

What percent of ventriculomegaly has other associated anomalies

Answer 18

33-60%

Question 19

What is the likelihood ratio for Down syndrome with an increased nuchal fold (6 mm or greater)

Answer 19

11-23.3

Question 20

What is the likelihood ratio for Down syndrome with ventriculomegaly

Answer 20

27.52