Design secondary analysis of prospectively collected registry data. Nhs fetal anomaly screening programme handbook 2018. This information has been produced on behalf of the nhs fetal anomaly screening programme. Nhs fetal anomaly screening programme phe screening. Nhs fetal anomaly screening programme chorionic villus sampling cvs and amniocentesis. These may be anatomic and physiologic problems with the health of the zygote, embryo, or fetus, either before gestation even starts as in preimplantation genetic diagnosis or as early in gestation as practicable. Detection rates of the fetal anomaly screening programme fasp 11 key conditions in one unit. Author links open overlay panel catherine hunsley tom farrell.
Prenatal diagnosis screening for fetal anomalies m. The majority of women believed that provision of extensive and detailed lists regarding fetal anomaly detection would only cause unnecessary anxiety and worry, and suggested that a less detailed approach is required for a routine screening programme for low. Uk national screening committee cfdna testing in the fetal anomaly screening programme 19 november 2015 aim 1. Screening for fetal anomalies by an ultrasound scan was introduced in many maternity units in the uk in the late 1970s and has become routine in most since then although there is little uniformity as to how the scan is performed and when it is offered. Model of best practice nhs fetal anomaly screening programme pct ces, nhs trust ces, sha ces, care trust ces, foundation trust ces, medical directors, directors of ph, directors of nursing, pct pec chairs. Public health screening programme annual report 1 april 2016 to 31 march 2017 published. Up to 5% of babies are born with a congenital abnormality. We investigated factors associated with the ct and fas uptake. Auditing these standards is complex, requiring an understanding oftrust size, case mix, the rarity of anomalies, screening uptake and the local obstetric population. In the context of screening, fetal medicine appointments will be given to women who. Two prenatal screening tests for congenital anomalies are offered to all pregnant women in the netherlands on an optin basis.
Maternity information system may be it or manual systems. Detection rates of the fetal anomaly screening programme. The overall aim of fetal anomaly screening is to identify potential problems so that parents can make an informed choice and to improve the safety of birth. Fetal anomaly screening programme how is fetal anomaly screening programme abbreviated. The uk national screening committee uk nsc was given responsibility by the department of health dh to oversee the implementation of a national strategy for downs syndrome screening which would improve the standard of local services and provide uniformity. Without nationwide access to anomaly scans, we continue to provide inadequate or inappropriate care to mothers and babies, which. The detection rate for spina bifida in populations that routinely offer second trimester ultrasound scans has been estimated at 68100%. The purpose of the fetal anomaly ultrasound scan is to detect significant structural fetal. Ultrasound the accuracy of ultrasound estimation the. Nhs fetal anomaly screening programme 7 introduction screening for fetal anomalies has been undertaken for many years in england although not part of a coordinated and uniform national programme.
Nhs fetal anomaly screening programme 9 including colleagues from northern ireland, scotland and wales and it quickly became clear that there was genuine will by stakeholders to work in unison. Have an anomaly suspected at the first trimester scan have had a combined test of 1. This programme aimed to improve the antenatal detection of congenital heart disease chd and its effect on fetal and postnatal outcomes. The screening tests are not guaranteed to find all problems. Fetal anatomy is assessed between 18 and 21 weeks of gestation. Nhs fetal anomaly screening programme screening for downs. The handbook is available on the antenatal screening wales professional website and will be. The nhs fetal anomaly screening programme wants to know how cascade training has impacted on the knowledge and confidence of participants who discuss the offer of screening for downs syndrome, edwards syndrome and pataus syndrome with women. Screening tests offered in pregnancy include ultrasound scans or blood tests. However, there is an increasing move towards the detection of the major fetal abnormalities before this time, optimally at the time of a scan between 11 and 14 weeks gestation. Nhs fetal anomaly screening programme handbook for laboratories.
The nhs fetal anomaly screening programme requires that there is equal access to uniform and qualityassured screening across england and that eligible women are provided with high quality information, so that they can make a personal informed choice about their screening options and pregnancy. Fetal anomaly screening programme fasp the fetal anomaly screening programme fasp offers screening to all eligible pregnant women in england to assess the risk of the baby being born with downs, andor edwards pataus syndromes or a number of fetal anomalies structural abnormalities of the developing fetus. They are used to check for specific physical abnormalities and conditions. The nhs fetal anomaly screening programme fasp has produced this handbook with support from the members of the programme advisory and task groups and in collaboration with health care professionals from around england. Uk nsc policy recommendations 20112014 model of best practice screening for downs syndrome. To ask the uk national screening committee uk nsc to make a recommendation based upon the evidence presented in this document on the introduction of cfdna as a contingent test within the uk fetal anomaly screening programme fasp. Downs syndrome, edwards syndrome and pataus syndrome screening. Uk national screening committee cfdna testing in the fetal. The nhs fetal anomaly screening programme fasp offers screening to all eligible pregnant women in england to assess the chance of the baby being born with downs syndrome, edwards syndrome or pataus syndrome or a number of fetal anomalies unexpected development of the developing fetus. The nhs fetal anomaly screening programme fasp is one of the antenatal and newborn nhs population screening programmes. Ultrasonography is used as a prenatal screening tool in the first trimester at 11 weeks for detection of fetal chromosomal abnormalities and major structural defects and in the second trimester at 1821 weeks for detecting structural fetal anomalies. Nhs fetal anomaly screening programme screening for downs syndrome. Nhs fetal anomaly screening programme screening for.
Fetal surgery for open spina bifida pubmed central pmc. Robust collection of outcome data is central to ensuring quality of service in relation to screening for fetal abnormalities. Extensive work has been undertaken since 2005 by the nhs fetal anomaly screening programme and the uk national screening committee to implement a national ultrasound screening programme for fetal anomalies in england. Nhs fetal anomaly screening programme annual report. However, the development of online decision aid option grid by the uk fetal anomaly screening programme fasp to support service users through fetal anomaly screening. Factors affecting the uptake of prenatal screening tests. Back in april 2016 the nhs fetal anomaly screening programme introduced a new key performance indicator kpi. The other fetal anomalies routinely screened for are trisomy 18 and. For the first time this has been addressed, and it gives me great pleasure to be able to introduce this document. This file may not be suitable for users of assistive technology. Pdf fetal anomaly screening for detection of congenital. Original article monitoring the prenatal detection of. A rigorous approach to the provision of information and to the consent process is therefore required. Enabling health boards to deliver effective, consistent and coordinated screening programmes to detect early signs of disease.
Ultrasound screening for fetal anomalies is routinely offered in the uk between 18 weeks 0 days and 20 weeks 6 days. They can then be offered information, further tests and appropriate treatment to reduce their risk andor any complications arising from the disease. This handbook is an easy reference guide to sonographers delivering the antenatal screening programme in wales. Fetal anomaly screening programme how is fetal anomaly. A clear strategy for improving areas of practice which fall below national standards is. The nhs fetal anomaly screening programme website gives information about fetal anomaly and downs syndrome, and how these conditions are tested during pregnancy if you have been seen in the genetics clinic in the past, please ask your gp or midwife to refer you back to us directly either before or early in a new pregnancy so that any new advice or options can be discussed with you.
This practical guidance supports healthcare professionals and stakeholders in the operational delivery of the screening pathway. Background in 2010, the uk fetal anomaly screening programme faspintroduced targets varying between 50% and 98% for the antenatal detectionof elevencongenital anomalies. P40 audit of the nhs fetal anomaly screening programme and. Nhs fetal anomaly screening programme screening for down. Whittle fetal abnormalities remain major contributors to perinatal mortality and morbidity and there seem to be good reasons to detect them at a time when it is still feasible to influence pregnancy outcome, by termination if necessary. The influence of maternal body mass index on fetal anomaly. Objectives this study describes the design, delivery and efficacy of a regional fetal cardiac ultrasound training programme. Fasp offers screening for pregnant women to check the baby for fetal anomalies, downs, edwards and pataus syndromes. Nhs fasp handbook for laboratories 6 introduction the purpose of this handbook is to bring together in one publication the nhs fetal anomaly screening programmes fasp policies, guidelines, recommendations, standards and specifications for downs syndrome t21, edwards syndrome t18 and pataus t syndrome screening that relate to the work performed by screening laboratories. Design setting and participants this was a prospective study that compared antenatal chd detection rates by professionals from. Setting seven multiplesource, populationbased congenital anomaly registers, members of the.
Fetal anomaly screening programme guys and st thomas. Definitions current uk national screening committee programmes for fetal screening are defined here as the national screening committee policy on fetal anomaly screening in pregnancy. Although the focus of the consent standards is the 1820 week fetal anomaly scan, these underlying principles apply to. The purpose of this handbook is to bring together in one publication the fetal anomaly screening programmes fasp guidelines and recommendations that relate to. Fetal alcohol syndrome diagnostic and prevention network. Prenatal testing consists of prenatal screening and prenatal diagnosis, which are aspects of prenatal care that focus on detecting problems with the pregnancy as early as possible.
Nhs public health functions agreement 201617 service specification no. Obstetric ultrasound handbook for sonographers delivering. The pathway of all the screening programmes will include diagnostic testing for confirmation of anomalies. Data collection and improvement methodology to raise standards.
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