Jugular lymphatic sacs in the first trimester of pregnancy: the prevalence and the potential value in screening for chromosomal abnormalities.

Objective: To investigate the prevalence of detectable jugular lymphatic sacs in a setting for first trimester screening for Down syndrome, and to evaluate the influence of jugular lymphatic sacs on the screening performance for chromosomal abnormalities.

Methods: A prospective single center study (Erasmus University Medical Center, Rotterdam, The Netherlands) over a period of one year (January 2003-February 2004). First trimester nuchal translucency measurement was performed in a study population of 415 fetuses. Additionally, the transversal plane with the spine and mandible was visualized to verify the presence of jugular lymphatic sacs. The jugular lymphatic sacs were measured anterior-posterior. The association between nuchal translucency and jugular lymphatic sacs was tested.

Results: Follow-up was complete in 406 cases (97.8%). Jugular lymphatic sacs could be visualized in 98 out of 415 (23.5%). The nuchal translucency thickness and the mean of the left and right jugular lymphatic sac were significantly correlated.

Conclusion: The sonographic visualization of jugular lymphatic sacs significantly predicts chromosomal abnormalities, although nuchal translucency is a better predictor. Nuchal translucency and jugular lymphatic sacs are strongly correlated and therefore not applicable in a combination test.