Screening Information for Downs Syndrome, Spina Bifida & Trisomy-18 Nuchal Translucency (NT)

Courtesy of Winnie Palmer Hospital Maternal Fetal Medicine.

This information is intended for patients who desire screening for Down syndrome, trisomy-18, and spinal bifida during your pregnancy. This information is not intended to substitute for any informed consent obtained by your primary obstetrician prior to undergoing screening or diagnostic testing in your pregnancy. This does not include all screening options available or the details of these options. More detailed information can be found in our pamphlet, "Screening Options for Chromosome Problems and spinal Bifida in Your Baby".

Types of testing offered through Winnie Palmer Hospital for Women and Babies:

  • New, more accurate screening tests for Down syndrome, trisomy-18 and spinal bifida are available. They include an ultrasound at 11-13 weeks in your pregnancy performed by a certified provider at Winnie Palmer Hospital for Women and Babies. During this ultrasound, the Nucal Translucency (NT) can be measured. The NT is a small area of fluid that occurs at the back of your baby's neck early in pregnancy. This ultrasound measurement is most helpful when combined with a blood test from the mother to determine the risk for Downs syndrome, trisomy-18 and spinal bifida in your baby.
  • Fully-Integrated Screen involves a NT measurement between 11-13 weeks in the pregnancy and 2 separate blood samples from the mother. At Winnie Palmer Hospital we perform the ultrasound and obtain the first blood sample in our ultrasound area for your convenience. The second blood sample is at our ultrasound area at Winnie Palmer Hospital or Lucerne Hospital Laboratory between 15-21 weeks in the pregnancy. Results are approximately 2 weeks after the second blood draw. This test is considered to be the most accurate screening test available. This replaces the Quad screen which is less accurate.
  • First Screen involves obtaining one blood sample from the mother at the time the NT measurement is obtained, which is 11-13 weeks of pregnancy. Both the ultrasound and the blood draw are done during the same visit at Winnie Palmer Hospital. This test is not quite as accurate as the Fully-Integrated Screen, but provides results approximately two weeks after the ultrasound, which is about one month sooner than the Fully Integrated Screen results. This is a good choice if you are considering an amniocentesis as soon as possible in your pregnancy if your baby is found to be at risk. The First Screen does not screen for spinal bifida. If you have the First Screen the mother can still get screened for spina bifida with a blood draw obtained from your doctor's office between 16-21 weeks.
For more information about this screen, the mother can request that your primary obstetrician refer you to meet with a Genetic Counselor. There are Genetic Counselors available in Winnie Palmer Hospital and can usually schedule a meeting the same day as your ultrasound.

What to do prior to NT testing

  • Decide if screening is desired for Downs syndrome, trisomy-18 and spina bifida in your pregnancy and discuss with your doctor which of these tests best meets your needs.
  • If screening is desired the Fully-Integrated Screen or the First Screen your doctors office will schedule you for your official NT ultrasound at Winnie Palmer Hospital. Be sure your appointment for your ultrasound is scheduled for between 11-13 weeks of pregnancy.
  • You may want to confirm with your insurance that they will cover the Fully-Integrated Screen or First Screen lab testing. All insurance companies do not cover these tests. The Fully-Integrated Screen lab work may cost up to $340 and the First Screen lab work may cost up to $130. To find out if your insurance plan covers the Fully-Integrated Screen lab work call them and give then the following billing codes: 83520, 82105, 84702, 82677, 86336. To find out if yourinsurance plan covers the First Screen lab work use the following billing codes: 83520, 84702. Your ultrasound and office visits are separate charges and are usually covered by insurance. If you are scheduled by your obstetrician for Genetics Consultation this is a separate charge that may/may not be covered by your insurance. You will be billed for tests and services not covered by your insurance.
  • Arrive the day of your appointment approximately 30 minutes before your scheduled time to allow for us to register you accurately.
  • You may valet park in front of Winnie Palmer Hospital, which costs $5.00 or you can also park in the parking deck, which costs $4.00. There is also metered parking available near the hospital, most patient visits last approximately 90 minutes.
  • When you enter Winnie Palmer Hospital go to the information desk just to your left. Ask for directions to the Hughes Center for Fetal diagnostics/Maternal Fetal Medicine offices, which are on the first floor of the Winnie Palmer Hospital.
  • You do not need to have a full bladder when you arrive for your NT ultrasound.

What NT testing involves:

  • The NT measurement involves an ultrasound to measure the small area of fluid that occurs at the back of the baby's neck early in pregnancy.
  • Usually the ultrasound can be performed on the mother's abdomen to get the measurement. Sometimes it may be necessary to do an ultrasound through the vagina to obtain the measurement. The ultrasound takes about 15 minutes to complete. We will confirm your due date and check the baby's heartbeat during the ultrasound.
  • We will inform you of the results of the NT ultrasound at the time of your scan.
  • After the ultrasound we will draw a blood sample in our office.
  • If you desire the Fully-Integrated Screen you will need to return to our office or go to Lucerne Outpatient Laboratory for your second blood draw. The Lucerne Laboratory is open 24 hours a day, 7 days a week and parking is free. It is located on the first floor of Orlando Regional Lucerne Hospital on the northwest corner of Orange Ave and Gore St. For specific directions call Orlando Regional Lucerne Hospital at 407-649-611.
  • If undergoing the Fully-Integrated Screen you will be mailed an order for the second blood draw. The second blood draw can be done between 15-21 weeks of pregnancy, but is most accurate when drawn between 16-18 weeks of pregnancy. When you go for your second blood draw you will need to bring the order form you received in the mail, a form of ID, and your insurance card. If you have not received the order for the second blood draw by the 16th week of pregnancy please call 321-841-8555 and ask to speak to Isabel Betancort, RN, Clinical coordinator.

Reporting of final results:

  • Your results are automatically sent from the lab to your primary obstetrician's office.
  • Your primary obstetrician who referred you to Winnie Palmer Hospital will give you your results.
  • Abnormal results should be followed by a detailed ultrasound at Winnie Palmer Hospital.

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