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Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation

CPT4 code

Name of the Procedure:

Ultrasound, pregnant uterus, real-time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation.

Summary

An ultrasound procedure that uses real-time imaging to measure the fluid collection at the back of a fetus's neck during the first trimester of pregnancy. This can be performed via the abdomen or vagina, depending on the specific circumstances.

Purpose

The primary goal is to assess the risk of chromosomal abnormalities, such as Down syndrome, and other potential congenital conditions in the developing fetus.

Indications

  • Pregnant women in their first trimester, generally between 11 and 14 weeks of gestation.
  • Those with a family history of genetic disorders or advanced maternal age.
  • As part of routine prenatal screening to ensure the well-being of the fetus.

Preparation

  • No fasting is required.
  • The patient might be asked to drink water and have a full bladder for a transabdominal ultrasound.
  • A transvaginal ultrasound does not normally require a full bladder.
  • Wear comfortable clothing that allows easy access to the abdominal area.

Procedure Description

  1. Positioning: The patient lies on an examination table.
  2. Approach: For a transabdominal approach, a conductive gel is applied to the abdomen. For a transvaginal approach, a transducer is inserted into the vagina.
  3. Imaging: The ultrasound transducer sends sound waves that create real-time images of the fetus on a monitor.
  4. Measurement: The healthcare provider measures the nuchal translucency, the fluid-filled space at the back of the fetus's neck.
  5. Documentation: Images and measurements are documented for further analysis and assessment by a specialist.

Duration

Approximately 20 to 40 minutes.

Setting

Typically performed in a hospital's obstetrics department, an outpatient imaging center, or a prenatal clinic.

Personnel

  • Ultrasound technician or sonographer.
  • Obstetrician or maternal-fetal medicine specialist.
  • Possible involvement of a genetic counselor for further assessment.

Risks and Complications

  • Minimal risk involved.
  • Discomfort from pressure or insertion of the transducer.
  • Rare possible urinary tract infection after a transvaginal approach.

Benefits

  • Provides early detection of potential chromosomal abnormalities and other congenital conditions.
  • Helps in making informed decisions regarding further testing and pregnancy management.
  • Non-invasive and safe for both mother and fetus.

Recovery

  • No specific recovery time required.
  • Normal activities can usually be resumed immediately after the procedure.
  • Follow-up appointments may be recommended based on the findings.

Alternatives

  • Non-Invasive Prenatal Testing (NIPT): Blood test with high accuracy but can be more expensive.
  • Chorionic Villus Sampling (CVS): Invasive test with higher risk but definitive results.
  • Second-trimester ultrasound screening.

Patient Experience

  • The procedure is generally painless, with slight discomfort during the transducer application.
  • Supportive care is available for discomfort or anxiety.
  • Results are typically discussed in a follow-up consultation, highlighting the importance of continued prenatal care.

Medical Policies and Guidelines for Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation

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