Quality of nuchal translucency measurements in The Netherlands: a quantitative analysis

Koster, Maria P. H.; Wortelboer, E. J.; Engels, Melanie; Stoutenbeek, P.; Elvers, L.H.; Visser, Gerard H.A.; Schielen, Peter C. J. I.

doi:10.1002/uog.6398

Cited by 25 publications

(24 citation statements)

References 31 publications

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“…More experienced operators, particularly those with a professional profile focused on fetal medicine, CRL over 60 mm, and FMF certification have a significant positive impact on the quality standards. In our series, typically and as previously published, there was a tendency to move the measurements closer to the median as the experience increases, with lower dispersion of the extreme values [4, 15, 16]. CRL range has also an impact, and measurements of NT in fetuses over 60 mm length seem to be more accurate (in terms of median MoM and logarithmic SD), similar to previous published experiences [4].…”

Section: Discussionsupporting

confidence: 89%

“…In our series, typically and as previously published, there was a tendency to move the measurements closer to the median as the experience increases, with lower dispersion of the extreme values [4, 15, 16]. CRL range has also an impact, and measurements of NT in fetuses over 60 mm length seem to be more accurate (in terms of median MoM and logarithmic SD), similar to previous published experiences [4]. Interestingly, each sonographer has the opportunity to compare its own measurements over time with the average measurements performed at the centre.…”

Section: Discussionsupporting

confidence: 81%

“…Moreover, data from our centre are representative of the expected distribution of NT compared to the Nicolaides reference curve. But interestingly, epidemiological monitoring of NT measurements shows that there are differences in each of the quality measures chosen, as previously published [4, 5, 14]. For example, the use of center-specific medians may mask important sonographer-to-sonographer variability.…”

Section: Discussionmentioning

confidence: 93%

“…In clinical laboratories, all tests are regularly subjected to quality controls to determine their reliability [1]. However, although rigid standardization of laboratory measurements has been traditionally well established [2, 3], clinically measurements such as ultrasound biometries have only recently been object of interest [1, 4–8]. …”

Section: Introductionmentioning

confidence: 99%

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Analysis of Quality of Nuchal Translucency Measurements: Its Role in Prenatal Diagnosis

Gabriel

Echevarría

Rodríguez

et al. 2012

The Scientific World Journal

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Objective. Quantitative analysis of the quality of nuchal translucency (NT) measurements. Methods. First-trimester combined screening for Down syndrome was performed to all pregnant women attended in our Department from October 2003 to November 2009. NT was measured according to the Fetal Medicine Foundation (FMF) criteria by 20 trained obstetricians. The performance of NT measurements was retrospectively analyzed with regard to several quality control standards. Accuracy according to experience, professional profile, crown rump length (CRL) values, and FMF certification was statistically tested. Results. A total of 14978 NT measurements were assessed. (1) The mean operator-specific median NT-MoM values was 0,98. (2) Mean percentage of cases >95th and <5th centiles were 5,0% and 4,2%, respectively. (3) Logarithmic mean and SD of the NT MoM values were 0,00 and 0,13, respectively. (4) The DR for trisomy 21 at screening time was 90,7% for a FPR of 6,7% for standard screening strategy. (5) According to Cumulative SUM (CUSUM) figures, the performance was more acceptable in FMF-certified operators. Conclusion. Overall, quality standards show optimal NT measurements in our unit. Operator experience, a dedicated profile to fetal medicine, CRL over 60 mm, and FMF certification have a significant positive impact on the quality standards.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Analysis of Quality of Nuchal Translucency Measurements: Its Role in Prenatal Diagnosis

Gabriel

Echevarría

Rodríguez

et al. 2012

The Scientific World Journal

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“…Die vorgeburtliche Risikoabklärung insgesamt sowie jede einzelne ihrer Komponenten (Ultraschall, laboratoriumsmedizinische Untersuchungen, Algorithmus) müssen einer kontinuierlichen Qualitätssicherung unterzogen werden. Durch eine kontinuierliche Qualitätssicherung kann das Problem der Unterschätzung der Nackentransparenz deutlich verringert und so die Entdeckungsrate erhöht werden [17,18,19]. Eine externe Qualitätssicherung ist insbesondere für den Bereich Ultraschall wesentlich, weil es sich bei der fetalen Nackentransparenz um eine Messung im Bereich um 0,1 mm handelt und deren Genauigkeit direkt von der Qualifikation des Anwenders abhängt [17].…”

Section: Begründungunclassified

Richtlinie der Gendiagnostik-Kommission (GEKO) für die Anforderungen an die Durchführung der vorgeburtlichen Risikoabklärung sowie an die insoweit erforderlichen Maßnahmen zur Qualitätssicherung gemäß 23 Abs. 2 Nr. 5 GenDG

2013

Bundesgesundheitsbl.

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Ultrasonographic Fetal Nuchal Translucency Measurements and Cytogenetic Outcomes

Bellai-Dussault,

Dougan,

Fell

et al. 2024

JAMA Netw Open

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ImportanceUltrasonographic measurement of fetal nuchal translucency is used in prenatal screening for trisomies 21 and 18 and other conditions. A cutoff of 3.5 mm or greater is commonly used to offer follow-up investigations, such as prenatal cell-free DNA (cfDNA) screening or cytogenetic testing. Recent studies showed a possible association with chromosomal anomalies for levels less than 3.5 mm, but extant evidence has limitations.ObjectiveTo evaluate the association between different nuchal translucency measurements and cytogenetic outcomes on a population level.Design, Setting, and ParticipantsThis population-based retrospective cohort study used data from the Better Outcomes Registry &amp; Network, the perinatal registry for Ontario, Canada. All singleton pregnancies with an estimated date of delivery from September 1, 2016, to March 31, 2021, were included. Data were analyzed from March 17 to August 14, 2023.ExposuresNuchal translucency measurements were identified through multiple-marker screening results.Main Outcomes and MeasuresChromosomal anomalies were identified through all Ontario laboratory-generated prenatal and postnatal cytogenetic tests. Cytogenetic testing results, supplemented with information from cfDNA screening and clinical examination at birth, were used to identify pregnancies without chromosomal anomalies. Multivariable modified Poisson regression with robust variance estimation and adjustment for gestational age was used to compare cytogenetic outcomes for pregnancies with varying nuchal translucency measurement categories and a reference group with nuchal translucency less than 2.0 mm.ResultsOf 414 268 pregnancies included in the study (mean [SD] maternal age at estimated delivery date, 31.5 [4.7] years), 359 807 (86.9%) had a nuchal translucency less than 2.0 mm; the prevalence of chromosomal anomalies in this group was 0.5%. An increased risk of chromosomal anomalies was associated with increasing nuchal translucency measurements, with an adjusted risk ratio (ARR) of 20.33 (95% CI, 17.58-23.52) and adjusted risk difference (ARD) of 9.94% (95% CI, 8.49%-11.39%) for pregnancies with measurements of 3.0 to less than 3.5 mm. The ARR was 4.97 (95% CI, 3.45-7.17) and the ARD was 1.40% (95% CI, 0.77%-2.04%) when restricted to chromosomal anomalies beyond the commonly screened aneuploidies (excluding trisomies 21, 18, and 13 and sex chromosome aneuploidies).Conclusions and RelevanceIn this cohort study of 414 268 singleton pregnancies, those with nuchal translucency measurements less than 2.0 mm were at the lowest risk of chromosomal anomalies. Risk increased with increasing measurements, including measurements less than 3.5 mm and anomalies not routinely screened by many prenatal genetic screening programs.

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Quality of nuchal translucency measurements in The Netherlands: a quantitative analysis

Abstract: Objective The Dutch Centre for Population Research has specified quality demands for nuchal translucency (NT)

Cited by 25 publications

References 31 publications

Analysis of Quality of Nuchal Translucency Measurements: Its Role in Prenatal Diagnosis

Analysis of Quality of Nuchal Translucency Measurements: Its Role in Prenatal Diagnosis

Richtlinie der Gendiagnostik-Kommission (GEKO) für die Anforderungen an die Durchführung der vorgeburtlichen Risikoabklärung sowie an die insoweit erforderlichen Maßnahmen zur Qualitätssicherung gemäß 23 Abs. 2 Nr. 5 GenDG

Ultrasonographic Fetal Nuchal Translucency Measurements and Cytogenetic Outcomes

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