Auditing ultrasound assessment of fetal nuchal translucency thickness: A review of Australian national data 2002–2008

Nisbet, Debbie; Robertson, A. C.; Schluter, Philip J.; McLennan, Andrew; Hyett, Jon

doi:10.1111/j.1479-828x.2010.01207.x

Cited by 10 publications

(13 citation statements)

References 16 publications

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“…NT underestimation has already been widely described by various authors . Results similar to ours have been recently reported by the Nuchal Translucency Quality Review (NTQR) program in United States, who found an undermeasurement of TN compared with expected values and considerable variability between providers.…”

Section: Discussionsupporting

confidence: 87%

Sonologist's characteristics related to a higher quality in fetal nuchal translucency measured in primary antenatal care centers

et al. 2019

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Objective To assess the quality of nuchal translucency (NT) measurements in primary care and the sonologist's characteristics related with a higher quality. Methods The median NT expressed in multiples of the median (MoM) was calculated for each sonologist of 14 participating antenatal primary care centers of the Catalan Institute of Health. A survey to the sonologists was used to establish variables related to higher‐quality measurements. Results The median NT MoM obtained in 16 448 NT measurements, performed by 102 sonologists, was 0.94 MoM. NT underestimation was observed in 46% of the sonologists. Underestimation were less frequent among professionals who performed more than 230 ultrasounds per year (26% vs 53%;p = .022), those who completed the online Fetal Medicine Foundation (FMF) course (22% vs 54%; p = .021), and those who were subject to periodic audits (24% vs 56%; p = .021). Underestimation rate decreased from 60%, to 33% and 14% with the increase of the years of experience from less than 5 years, to 6 to 15 years and more than 15 years of experience, respectively (p = .029). Conclusions Higher‐quality measurements were demonstrated in sonologists who performed more ultrasounds per year, those with more years of scanning experience, those who completed the online FMF course, and those periodically audited.

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Section: Discussionsupporting

confidence: 87%

Sonologist's characteristics related to a higher quality in fetal nuchal translucency measured in primary antenatal care centers

et al. 2019

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“…Irrespective of which measurement has the higher utility, auditing an operator's measurement distribution against a valid reference range will improve the precision of measurement and the accuracy of screening, as has been clearly shown in nuchal translucency screening [28,29,30]. Further research defining the best quality assurance process for uterine artery Doppler assessment using distributional analysis and cumulative summation assessment of operator performance is underway.…”

Section: Discussionmentioning

confidence: 99%

Uterine Artery Pulsatility Index Assessment at 11-13<sup>+6</sup> Weeks' Gestation

Ridding

Schluter²,

Hyett³

et al. 2014

Fetal Diagn Ther

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Introduction: First-trimester uterine artery pulsatility index (PI) measurements form part of an algorithm used to assess the risk of developing pre-eclampsia. The objective of this study was to construct a population-specific reference range for both the lower and mean maternal uterine artery PI at 11-13⁺⁶ weeks' gestation and to assess measurement agreement. Materials and Methods: Reference ranges for mean and lower PI measurements were developed using polynomial regression models following prospective collection of maternal uterine artery PI measurements at 11-13⁺⁶ weeks' gestation. Measurement agreement studies were performed by two experienced operators. Results: Measurements from 298 women were included in the primary study. Polynomial regression indicated no change over gestational age for the lower PI (mean 1.44). There was an inverse relationship between the average PI and gestational age (mean [0.8960 + (2.9771 × CRL^-1/2)]²). PI measurement agreement was good-strong (intraclass correlation (ICC) 0.50-0.79) between operators, and within-operator agreement was almost perfect (ICC 0.88-0.93). Conclusions: Reference ranges for both the average and lowest PI of the maternal uterine arteries were derived at 11-13⁺⁶ weeks' gestation. This will provide a basis for development of auditable standards for first-trimester uterine artery Doppler measurements. The PI measurements are reproducible and reliable.

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“…19,20 Closer inspection of these studies showed that the effectiveness of screening may, in part, be dependent on the method of nuchal translucency assessment; best limited to the 11 to 13 + 6 gestational age range, defining gestational dependent ranges rather than using a fixed cut-off limit for nuchal translucency. [45][46][47][48] The pathophysiology leading to increased nuchal translucency is not completely understood. 14, The most recent improvements in the performance of nuchal translucency as a screening tool for trisomies have been based on improved statistical modelling of the data rather than on changes in measurement technique.…”

Section: Value Of Examining the Fetusmentioning

confidence: 99%

First Trimester Ultrasound Assessment for Fetal Aneuploidy

Hyett

Mogra

Sonek

2014

Clinical Obstetrics &Amp; Gynecology

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Screening tests for trisomy 21 have gradually become more refined and now involve complex statistical models that combine demographic, biophysical, and biochemical parameters to produce individualized risk estimates for pregnant women. An understanding of the evolution of the principles, methods, and statistical techniques applied to Down syndrome screening is valuable as these processes can be transferred to other, more prevalent, adverse pregnancy outcomes. First trimester ultrasound forms the foundation of this process.

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Auditing ultrasound assessment of fetal nuchal translucency thickness: A review of Australian national data 2002–2008

Cited by 10 publications

References 16 publications

Sonologist's characteristics related to a higher quality in fetal nuchal translucency measured in primary antenatal care centers

Sonologist's characteristics related to a higher quality in fetal nuchal translucency measured in primary antenatal care centers

Uterine Artery Pulsatility Index Assessment at 11-13<sup>+6</sup> Weeks' Gestation

First Trimester Ultrasound Assessment for Fetal Aneuploidy

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