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Innovations in Pregnancy Care

An illustration for a blog post about a London Pregnancy Clinic event, depicting a serene winter scene with a doctor holding a snowflake wand beside a giant, glowing snow globe. Inside the globe, a peaceful foetus is curled up, akin to a budding flower on a tree branch, symbolising the clinic's nurturing approach to prenatal care.

Innovations in Pregnancy Care

An evening dedicated to LPC’s commitment towards “Innovative Pregnancy Care”

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London Pregnancy Clinic’s recent “Innovative Pregnancy Care” event was a confluence of expertise and insight, shaping the future of prenatal care. Leading professionals gathered to discuss breakthroughs in early diagnostics and patient education, emphasising LPC’s forward-thinking approach.

A December evening at Spitalfields Market was transformed into a hub of medical expertise during the London Pregnancy Clinic’s event. The focus was on pioneering approaches in prenatal care, particularly the 10 Week Scan,  Non-invasive prenatal testing (NIPT), and pre-eclampsia diagnosis.

Advancing the 10 Week Scan

The evening began with Ms. Shaz Khojasteh, LPC’s clinical lead, greeting each attendee with a warmth that matched her expertise. Her introduction was not just an opening speech but a heartfelt welcome to LPC’s family. She shared with the audience our signature 10 Week Scan, which isn’t just a routine check. It’s a comprehensive examination of the baby’s anatomy, providing vital developmental insights at a crucial early stage, thereby enriching the information gathered before conducting NIPT.

Demystifying NIPT – Dr Fred Ushakov’s Perspective

The spotlight then shifted to Dr. Fred Ushakov, whose speech was not only insightful but also visionary. He spoke passionately about his mission, in collaboration with the London School of Ultrasound and UCLH, to train the next generation of doctors and sonographers. His goal is to equip them with the skills and knowledge necessary to leverage early pregnancy scans to their full potential, enhancing patient care and pregnancy outcomes. This mission, he explained, is vital in ensuring that every pregnancy is approached with the utmost care and precision.

Dr Ushakov then addressed a common misunderstanding about NIPT. He emphasised that while NIPT is effective, it’s not all-encompassing. Patients may misinterpret it as a guarantee against all prenatal issues, not realising that conditions more severe than Down’s syndrome can occur and cannot be detected by NIPT. He further highlighted the importance of the dual approach (watch the explainer video here) that he instilled at LPC. Dr. Ushakov’s call for broader education and comprehensive scanning techniques underscored the need for a more informed approach to prenatal care.

Advocacy for Pre-eclampsia Awareness

Next, we were captivated by Dr. Daniel Stott, whose talk about pre-eclampsia was as enlightening as it was heartfelt. It was clear from his words and the energy in his voice just how dedicated he is to this topic. Dr. Stott walked us through the workings of a groundbreaking blood test for pre-eclampsia. With an approachable manner, he explained how this test isn’t just for identifying pre-eclampsia; it’s a crucial tool in carefully guiding expectant mothers through the rest of their pregnancy. 

Conclusion

As the expert talks wrapped up, the event naturally transitioned into festive networking. It was a perfect opportunity for attendees to connect, exchange experiences, and build professional ties in a holiday atmosphere. The evening emerged as a crucible of innovative ideas and shared goals for advancing prenatal care. Leaving the market, we carried with us the night’s insights and a renewed hope for the future of prenatal health. The event proved to be not just a confluence of minds but a beacon of hope for prenatal care’s future.

A special thank you to our sponsors Eurofins.

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10 Week Pregnancy Scan Explained

Graphic of 10 week Scan. An illustration of a mother thinking about the normal development of her baby.

The 10-Week Scan

Answering your questions about the Earliest Anomaly Scan At 10 Weeks

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This blog post discusses the benefits of the 10-week scan, how it is done, and frequently asked questions. It also highlights that the 10-week scan is the best scan to combine with Non-invasive prenatal testing (NIPT), which is a blood test that can be done at 10 weeks to screen for common chromosomal abnormalities. At the London Pregnancy Clinic, We have a unique and individual approach in that we do not ‘leave any stone unturned’ – we provide the most comprehensive assessment of the development of your baby possible at each stage of pregnancy.

Understanding the 10-week Scan:

Typically, the 10-week scan is performed using either a transabdominal or transvaginal ultrasound. A skilled sonographer will place a transducer on your abdomen or within your vagina. This transducer emits sound waves into the uterus, bouncing off the fetus to create a real-time image on the ultrasound screen. The entire procedure generally lasts between 15 to 30 minutes.

Comprehensive Screening:  

In the realm of prenatal care, knowledge is power. The 10-week pregnancy scan, often regarded as the earliest anomaly scan, holds a special place in the hearts of expecting parents. It’s an opportunity to unveil critical insights into your baby’s development, offering early detection of potential fetal anomalies and precise pregnancy dating. This pivotal examination, conducted through either a transabdominal or transvaginal ultrasound, is an indispensable tool in ensuring a smooth and informed journey towards parenthood.

Benefits of the 10-week Scan:  

The advantages of the 10-week scan are numerous and profound:

Early Detection of Fetal Abnormalities: At the 10-week mark, this scan can identify up to 10 major fetal anomalies, providing parents with vital information to make informed choices about their pregnancy.

Accurate Pregnancy Dating: Precise dating of the pregnancy aids parents in planning for their baby’s arrival and arranging future prenatal appointments with confidence.

Reassurance for Parents: Pregnancy is a time of great joy but can also bring anxiety. The 10-week scan offers peace of mind, assuring parents that their pregnancy is progressing as expected.

Optimal Pairing with NIPT: When combined with NIPT, the 10-week scan offers the most accurate information on the baby’s health. NIPT, a blood test conducted at 10 weeks, screens for common chromosomal abnormalities, such as Down syndrome, trisomy 13, and trisomy 18, complementing the 10-week scan perfectly.

IS THE 10-WEEK SCAN FOR ME?

Many pregnant women in the UK are anxious about the health of their babies in the early weeks of pregnancy. This may be due to a number of factors, including:

  • Previous miscarriage
  • IVF pregnancy
  • Unintentional alcohol consumption
  • Missed doses of folic acid
  • Use of certain medications
  • Severe morning sickness
  • Bleeding
  • Unhealthy diet
  • Sudden loss of pregnancy symptoms

If you are concerned about any of these issues or others, our 10-week scan is the perfect solution for you. It is designed to provide early reassurance for expectant parents.

The 10-week scan is also ideal for any pregnant woman who wishes to have NIPT at the earliest possible stage. Many parents choose to screen for the risk of Down syndrome in the first trimester. This is now possible with a non-invasive blood test at 10 weeks. However, the majority of fetal abnormalities are structural (physical), and some of these may be more severe than Down syndrome.

Unfortunately, NIPT will miss all structural abnormalities. That is why we take the opportunity to conduct an early screening of the baby’s structures to rule out 10 major structural abnormalities before performing NIPT.

Should I Delay My NIPT until 12-14 Weeks, Post NHS NT Scan?

Opting to delay your NIPT until after your NHS (National Health Service) Nuchal Translucency (NT) scan at 12-14 weeks is an approach that is becoming increasingly outdated. We firmly believe that the most effective method is to perform both the dating scan at 10 weeks and the NIPT at 10-11 weeks. This approach offers several advantages, particularly regarding early testing.

Admittedly, some fetal structures and organs may not be fully visualized at the 10-week mark, and certain structural anomalies may remain undiagnosed due to the fetus’s ongoing development. However, the benefits of conducting both tests as early as technically feasible outweigh these limitations.

  • IVF pregnancy
  • Unintentional alcohol consumption
  • Missed doses of folic acid
  • Use of certain medications
  • Severe morning sickness
  • Bleeding
  • Unhealthy diet
  • Sudden loss of pregnancy symptoms

If you are concerned about any of these issues or others, our 10-week scan is the perfect solution for you. It is designed to provide early reassurance for expectant parents.

The 10-week scan is also ideal for any pregnant woman who wishes to have NIPT at the earliest possible stage. Many parents choose to screen for the risk of Down syndrome in the first trimester. This is now possible with a non-invasive blood test at 10 weeks. However, the majority of fetal abnormalities are structural (physical), and some of these may be more severe than Down syndrome.

Unfortunately, NIPT will miss all structural abnormalities. That is why we take the opportunity to conduct an early screening of the baby’s structures to rule out 10 major structural abnormalities before performing NIPT.

Your Frequently Asked Questions About 10-week Scan

Do I need a full bladder for the 10-week scan? No, a full bladder is not necessary for the 10-week scan.

What sets the 10-week scan apart from the nuchal translucency scan? In comparison to the nuchal translucency scan, the 10-week scan is more comprehensive. While both can measure the fluid at the back of the baby’s neck, the 10-week scan extends its scope to assess various aspects of the baby’s development, including the heart, brain, and spine.

Is the 10-week scan safe? Yes, the 10-week scan is a safe and well-established procedure. Ultrasound technology has been a trusted method for safely imaging babies in the womb for many years.

Conclusion

If you’re considering delaying your first scan or wish to explore further options, the London Pregnancy Clinic provides innovative Early Ultrasound Screenings. These include the Early Fetal Scan, conducted between 12 and 16 weeks, which can exclude more than one hundred serious anomalies. Moreover, our Early Fetal Echocardiography is designed to identify up to 80% of detectable severe fetal heart defects. We highly recommend this scan for all babies with increased nuchal translucency (NT) measurements, fetal anomalies, or other unusual findings detected at the 11-13 week scan.

In conclusion, the 10-week pregnancy scan is an essential early step in ensuring the health and well-being of your growing family. It empowers parents with valuable insights and peace of mind, setting the stage for a smooth journey into parenthood. And remember, at the London Pregnancy Clinic, we offer a range of pioneering early ultrasound screenings to cater to your specific needs, ensuring the best possible care for your precious one.

Book NIPT + Scan from £490

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Understanding NT’s 95th Percentile

Graphic of understanding NT's 95th Percentile. A baby on a timeline with abstract representations of measuring tools.

Understanding NT’s 95th Percentile:

Nuchal Translucency (NT) Thickness Measurements in the 1st Trimester and What to Do if NT is Increased?

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Nuchal Translucency (NT), developed over 30 years ago in the early 1990s, remains a pivotal screening marker for evaluating early fetal well-being. Widely used, it screens for chromosomal and genetic conditions, as well as heart defects and other structural anomalies in the developing fetus. To get an understanding of NT’s 95th percentile we will discuss the importance of NT measurements, variations in cutoff values, and what to do if your baby’s NT measurement falls above the 95th centile but below the 3.5mm threshold.

The Significance of Nuchal Translucency Measurements:

NT refers to measuring the clear fluid space at the back of the baby’s neck during an ultrasound scan. According to NHS guidelines, it is measured between the 11th and 14th weeks of gestation. Presently, it is a cornerstone of the NHS Chromosomal Syndromes Screening Program conducted through Combined Screening Testing (CST). This program relies on the enduring significance of NT to assess the risk of chromosomal syndromes in the first trimester of pregnancy. Elevated NT measurements can indicate potential chromosomal abnormalities such as trisomy 21 (Down syndrome) and genetic conditions like Noonan syndrome, as well as heart defects and other structural anomalies. However, there is a significant level of uncertainty regarding what constitutes an abnormal NT measurement.

Variations in Cutoff Values:

One of the challenges with NT measurements is determining what constitutes an abnormal measurement. There is considerable variation in the cutoff values used by different research papers and guidelines. The majority of research studies and international society guidelines use the 95th centile as the threshold for abnormal NT measurements. This means that if your baby’s NT measurement falls below the 95th centile, it is considered normal. However, the NHS guidelines use a more conservative cutoff of 3.5mm. This 3.5mm cutoff is equivalent to the 99th percentile, representing a higher threshold for what is considered abnormal by NHS.

The Importance of Gestational Age:

It’s crucial to understand that the 95th centile for NT measurements varies with gestational age. Younger fetuses at 11 weeks tend to have naturally smaller NT measurements compared to those closer to 14 weeks. Therefore, determining whether your baby’s NT measurement is normal or not depends on both the absolute measurement and the gestational age.

Understanding NT’s 95th Percentile Measurements:

We understand that expectant parents might find it challenging to locate validated data concerning the 95th centile cutoff for their baby, as such data is not readily accessible online. To provide support, we have developed an NT thickness reference table based on highly esteemed international data from the study conducted by Wright et al in 20081. Additionally, we have cross-referenced data on normal NT measurements for the 10-11-week gestational period from Grande et al.’s publication in 20142, which closely aligns with Wright’s findings. Consequently, we have assembled a table that delineates the limit of an increased NT (95 centile) for each week from the 10th to the 14th week, utilising gestational age data recommended by the British Medical Ultrasound Society (2009)3.


Gestational Weeks 10+0 10+1 10+2 10+3 10+4 10+5 10+6 11+0 11+1 11+2 11+3 11+4 11+5 11+6 12+0 12+1 12+2 12+3 12+4 12+5 12+6 13+0 13+1 13+2 13+3 13+4 13+5 13+6 14+0 14+1
NT 95th centile mm 2.3 2.3 2.4 2.4 2.4 2.4 2.3 2.2 2.2 2.2 2.2 2.2 2.2 2.2 2.3 2.3 2.4 2.4 2.5 2.6 2.6 2.7 2.7 2.7 2.8 2.8 2.8 2.8 2.8 2.8

Our chart represents the distribution of increased NT measurements (> 95th centile) in relation to the gestational age. It’s important to note that, at every stage of gestation, normal NT measurements remain below 2.8 mm. Therefore, any NT measurement equal to or greater than 2.8 mm is considered elevated.

What occurs when there is a significant elevation in NT measurements? 

If NT thickness is 3.5mm or more (>99th centile) you will be referred to the fetal medicine unit (FMU) of your NHS hospital or FMU of a large regional NHS trust, where doctors will scan your baby to exclude structural anomalies associated with increased NT and offer further tests (CVS or NIPT). They will also offer fetal echocardiography at 16-20 weeks to exclude associated CHD.

What to Do if NT Measurement is Above the 95th Centile but Below 3.5mm (99th centile)?

The NHS adopts a conservative approach and does not acknowledge the 95th centile raised NT cutoff. Consequently, additional scans and tests are not scheduled for these babies before the routine 20-week anomaly scan conducted by the NHS. However, when the NT measurement surpasses the 95th percentile, it is advisable to proceed with further testing. In such instances, considering Non-invasive Prenatal Testing (NIPT) and an Early Fetal Anomaly Scan (Early Fetal Scan) are recommended.

SMART TEST – A Comprehensive Screening Option

For babies with elevated NT (between 95-99th centile), we have introduced the SMART TEST, which stands as the most advanced early reassurance package available. It comprises two expert early anomaly scans, Early Fetal Echocardiography, and the most comprehensive state-of-the-art NIPT panel. The SMART TEST can effectively rule out the majority of severe congenital heart defects (CHDs) and other structural anomalies associated with elevated NT, and reduce the probability of your baby being affected by chromosomal, genetic, or structural abnormalities.

While the SMART TEST is expensive, it is the most comprehensive early reassurance package available in the UK. For parents unable to afford the SMART TEST, there is a more affordable option of the Early Fetal Scan and an extended Panorama Test. The Early Fetal Scan screens for CHDs, but does not include a detailed examination of the fetal heart. You can further upgrade the scan and Panorama Test NIPT package to include eECHO.

If you have received concerning news about your baby’s increased nuchal translucency, we strongly recommend discussing the SMART TEST with one of our specialists.

Conclusion

Nuchal translucency measurements play a crucial role in assessing fetal well-being during the first trimester of pregnancy. Understanding the variations in cutoff values, gestational age, and available screening options is essential for making informed decisions if your baby’s NT measurement falls above the 95th centile but below the 3.5mm NHS threshold (99th centile). The SMART TEST, with its comprehensive NIPT panel and early fetal echocardiography, offers a valuable non-invasive screening option for parents seeking more information about their baby’s health. We are committed to offering you the best possible care, and you are always welcome to have a personal consultation with us to decide on the most suitable approach based on your individual circumstances.

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NIPT and Scan: Why We Champion This Dual Approach

Graphic of a baby footprint in a heart with DNA strand on either side.

NIPT and Scan Approach: Why We Champion This Screening Method at London Pregnancy Clinic

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At the London Pregnancy Clinic, we’re dedicated to providing expectant mothers with advanced screening options and the highest level of care. We firmly recommend combining Non-Invasive Prenatal Testing (NIPT) and Ultrasound screening. Let’s explore why we endorse NIPT and Scan approach and how it benefits our patients.

Why Choose Both NIPT and scan?

Comprehensive Screening:  

Ultrasound visually assesses the baby’s anatomy, checking for physical abnormalities and measuring growth. NIPT, known by brand names like Natera’s Panorama AI or Eurofins’ PrenatalSafe, examines fetal DNA in the mother’s bloodstream, providing insights into potential chromosomal abnormalities like Down’s Syndrome, Edwards syndrome, and Patau syndrome.

Increased Accuracy and Early Detection:  

By merging Ultrasound’s structural insights with genetic data from NIPT, we significantly reduce false positives and offer more accurate results. As early as 10 weeks, when your baby is the size of a strawberry, we initiate the dual screening process. At this stage, we conduct the earliest possible structural anomaly scan, the Ten-week Anomaly Scan, to search for structural anomalies that NIPT can’t detect. We can rule out severe physical abnormalities like Acrania, Spina bifida, Absence of arms, hands, legs or feet, and Alobar holoprosencephaly. Only after confirming your baby’s structural development do we proceed with the NIPT test.

UNDERSTANDING THE TECHNOLOGY

Ultrasound Screening: 

Ultrasound employs sound waves to create images of the baby in the womb. A small probe, called a transducer, moves over the mother’s abdomen. The transducer emits high-frequency sound waves that bounce off the baby’s structures, and these echoes are converted into images on a screen.

Non-Invasive Prenatal Testing (NIPT): 

NIPT is a simple blood test taken from the expectant mother. This test detects tiny fragments of the baby’s DNA circulating in the mother’s bloodstream. By analysing these fragments, we can determine the risk of certain chromosomal conditions.

Is It Safe?

Absolutely. Both Ultrasound and NIPT are non-invasive and pose minimal to no risk to both mother and baby. However, it’s important to note that while NIPT is highly effective, it’s not a definitive diagnostic test. In cases of low negative predictive value, our doctors may recommend invasive tests like CVS or amniocentesis, which carry minimal miscarriage risk.

Our NIPT Options

As early as…
  • 10 weeks

  • 9 weeks

  • 10 weeks

Turnaround (Working Days)
  • 2-4

  • 5-7

  • 5-7

Lab Location
  • UK

  • US

  • US

No Call Results
  • <1%

  • <1%

  • <1%

Redraw Rate
  • 2%

  • 3%

  • 2%

Edward’, Patau & Down’s Syndrome
Di George Syndrome (22q del)
Triploidy
Turner Syndrome (45X)
Sex chromosomes aneuploidies
Twin pregnancies
  • Best

Vanishing twin syndrome
Fetal sex reveal (optional)
Scan + NIPT Price
  • £540

  • £540

  • £490

Extended NIPT + Scan Options
  • SMART Test £1690

  • Microdeletions £790

  • Rare Diseases £790

Other Early Ultrasound Screenings Offered

For those looking to delay their first scan, London Pregnancy Clinic offers pioneering Early Ultrasound Screenings, including the Early Fetal Scan conducted between 12 and 16 weeks, which can exclude more than one hundred serious anomalies. Additionally, our Early Fetal Echocardiography is designed to identify up to 80% of detectable severe fetal heart defects. It is a scan we highly recommend this scan for all babies with increased nuchal translucency (NT) measurements, fetal anomalies, or other unusual findings detected at 11-13 weeks scan.

Conclusion

At the London Pregnancy Clinic, we believe in providing the most comprehensive care possible. By endorsing the dual Ultrasound and NIPT approach, we ensure that our patients receive a detailed, accurate, and safe assessment of their baby’s health. Whether you choose the ten-week scan or another early anomaly scan, we’re here to guide and support you every step of the way.

If you have further questions or would like to schedule an NIPT and scan, please contact the London Pregnancy Clinic.

Book NIPT + Scan from £490

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