Who performs NT and how » Who
In the video: what measures the specialist when it performs the study of nuchal translucency
The doctor is the one responsible of the procedure. You can find in this website the list (last updated on 01 July 2013) of all italian practitioners who have been accredited.
As this is a recently introduced test, the practitioner will not be able to take the examination to become accredited as part of a university course; however he/she knows that the introduction of pre-natal screening has significant ethical, social and legal impact and therefore it is is very important that is fully trained through these courses.
On a volutary basis he/she can pass the accreditation process that has been put in place by an international medical foundation (Fetal Medicine Foundation) and be certified to perform the screening. The aim of the foundation is to improve the training available to medical practitioners who want to be specialized in pre-natal screening.
Based in London, the foundation exercises quality control by ensuring that practitioners are certified on a yearly basis. Both the certification process and access to the risk calculation software and the quality control are offered by the Fetal Medicine Foundation free of charge.
The quality control is done through the examination of images and the analysis of the data entered in the software that the practitioner sends to the centre on a yearly basis. Access to the software is given on individual basis depending on the outcome of his/her accreditation.
It is the practitioner’s responsibility to ensure that the values received from the ultrasound and laboratory are correctly entered in the software. This will also enable the practitioner to constantly monitor his/her own data. This is the reason why the accreditation is done on an individual basis and not collective, by certifying the center where the where the practioner works.
When using licensed software, the report will have the name and individual identification number (FMF ID) of the practitioner who is authorized to use the software for risk calculation. If this is not the case, the reliability of the screening and result cannot be guaranteed, as the practioner may not have been through the quality control process.
In addition to the nuchal translucency, the practitioner can use other markers, which will enable him/her to improve the screening’s detection rate.
For each of these additional markers, it is required that the practitioner undergoes through an initial certification process and yearly accreditation.
Given that precision and measurements of fetal structures (tenth of a millimeter) is essential in risk calculation, the equipments used by the practitioner to perform the screening have to be of high standard. In order to improve the detection rate, the nuchal translucency screening has to take into account the age related risk, the measurement of the NT, other markers and maternal blood.
In this case, the blood test that was performed on the mother between 9 and 13 weeks. Please note that since blood tests performed earlier in the pregnancy are more reliable it is advised that the blood test is conducted at around 9 weeks rather than 13
The doctor will need to ensure that the standard and quality of the blood test are of high standard and that he/she is using an accredited laboratory that has gone through a quality control for this procedure.
Finally an important part of the screening is the way results are discussed with the patient.
- Discussion of results which has to be done by the doctor in person and not by a letter sent by a laboratory.
PLEASE NOTE the screening will not provide an accurate morphology evaluation of the fetus. This is a diagnostic study and not just a screening and requires expertise, time and the right equipments.