Screening for Down syndrome with nuchal translucency is becoming more widespread. Training and credentialing sonographers is currently being provided by experts in fetal ultrasound, such as those administering the Society for Maternal Fetal Medicine’s Nuchal Translucency Quality Review (NTQR) program or the Fetal Medicine Foundation/USA (FMF/USA) program. The laboratory has the important role of establishing and maintaining appropriate reference values to interpret these NT measurements and to provide a patient risk that combines both the ultrasound and biochemical results. The laboratory also has a responsibility to monitor and evaluate NT measurements (e.g., epidemiological monitoring) to help assure quality prenatal screening. When many sonographers submit NT measurements, the task of interpreting and monitoring them can be overwhelming for the laboratory. Laboratories may not have the time, resources or expertise to perform these tasks at meaningful intervals. Unfortunately, laboratories may be held partially responsible if a poorly performing sonographer contributes to ‘missing’ a Down syndrome pregnancy.
With this as background, our First Trimester Interlaboratory Comparison Program (ICP) is now introducing a new service - NTMonitor. Prenatal screening laboratories can utilize NTMonitor as an adjunct to existing NT quality review. NTMonitor provides a quality assessment of the NT measurements that your laboratory receives, regardless of an individual sonographer’s source of accreditation. The assessment includes:
The operating principal of NTMonitor is collegial in which questions regarding NT interpretation and performance are encouraged and suggestions for improvement of NTMonitor are welcome.
To enroll your laboratory in NTMonitor:
George J. Knight, Ph.D. Glenn E. Palomaki, Ph.D.,
Jacob A. Canick, Ph.D. Geralyn M. Messerlian, Ph.D.,
Department of Pathology and Laboratory Medicine
Women & Infants Hospital, Providence , Rhode Island