First Trimester Screening (Nuchal Translucency and Blood Test)

Medically Reviewed by Traci C. Johnson, MD on June 09, 2023
2 min read

The first trimester screening is a safe, optional test for all pregnant women. It's a way of checking your baby's risk of certain birth defects, such as Down syndrome, Edward's syndrome (trisomy 18), trisomy 13, and many other chromosomal abnormalities, as well as heart problems.

Women carrying twins may be less likely to get the full first trimester screening. The results aren't as accurate as they are with single babies.

The screening involves two steps. A blood test checks for levels of two substances -- pregnancy-associated plasma protein-A (PAPP-A) and human chorionic gonadotropin. A special ultrasound, called a nuchal translucency screening, measures the back of the baby's neck. At times, the nuchal translucency test may add on ultrasound markers, such as measuring a baby's nasal bone.

The combined result of the blood tests and the ultrasound gives you a sense of your baby's risk. However, it's not a diagnosis. Most women who have an abnormal first trimester screening go on to have healthy babies.

Whether you get this test is your choice. Some women want the test so they can prepare. Others don't. They may decide that knowing the results wouldn't change anything. Or they feel that the test could result in unnecessary stress and invasive testing. However knowing of possible risks would allow for increased monitoring during your pregnancy as well as giving you delivery options (special hospital, pediatric surgeon availability).

The first trimester screen won't harm you or your baby. A technician will take a quick blood sample from your arm or fingertip. The nuchal translucency screening is a normal ultrasound. You'll lie on your back while a technician holds a probe against your belly. It will take between 20 to 40 minutes.

You should have the results in a few days. If your results are normal, your baby has a low risk of these birth defects. If they're abnormal, your doctor may suggest further tests to rule out problems. These could include ultrasounds or invasive procedures, like CVS or amniocentesis.

Try not to worry if your results are abnormal. Remember: This test can't diagnose birth defects. It only shows if your baby has a greater risk than average.

Sometimes your test results are combined with a second trimester screening. In that case, you may not get test results until your second trimester. Or you may get the results, and then get combined results after the second test.

You would get the first trimester screen once between the 11th and 13th week.

Nuchal test, integrated screening

Triple screen, quad screen, MSAFP, sequential screening