P06.06: Skin edema in first trimester fetuses

The aim of this study was to proof an association between generalized skin edema and the nuchal translucency thickness in first trimester fetuses. Furthermore we investigate the predictive value of a skin edema for aneuploidy and structural anomalies in a high risk collective. In this retrospective study all fetuses with a NT above 2.2 mm were included from our databank between 2004 and 2009. Statistical significance was calculated with Chi-squared-test (P < 0.05). A total of 237 fetuses with a median CRL of 68.8 mm (range: 40–84 mm) and a median NT of 3.0 mm (range: 2.3–14.2 mm) were included in this study. 4.4% (11/248) were excluded because of missing pregnancy outcomes. 17.3% (41/237) presented with skin edema. The rate of skin edema was 1.3% in the group with NT < 95. percentile, 2.7% in the group with NT between the 95.–99. percentile, 17.5% with NT of 3.5–4.4 mm, 36.4% with NT of 4.5–5.4 mm, 54.5% with NT of 5.5–6.4 mm and 95.5% with NT above 6.5 mm. 19% (45/237) had chromosomal disorders. The rate of aneuploidy was 61% in the group with skin edema and significantly higher compared to 10.2% in those without skin edema (P < 0.0001). In the group of fetuses with normal karyotype 12% (23/192) presented with structural anomalies. The rate of anomalies was 43.8% in the group with skin edema and significantly higher compared to 9.1% in those without skin edema (P < 0.0005). 56.3% (9/16) of fetuses with skin edema and normal karyotype had a normal anatomy. In the group with normal anatomy skin edema resolved spontaneously in 77.8% during the second trimester. Our data show a clear association between the thickness of NT and the rate of skin edema. Skin edema has a high predictive value for aneuploidy or structural malformations. Therefore, the fetuses with skin edema should have early malformation scan in case of normal karyotype.