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R: Nuchal translucency testing From: Andrea Corda (acord@tin.it) Mon Mar 19 14:37:36 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Andrea Corda: "R: 3D" Previous message: DuboseTerryJ@uams.edu: "Re: 3D" I agree completely. One thing arises a few questions in my mind and it is:I often have to re-measure Nuchal Translucency in patients that have already performed this test in other places that are accredited by the FMF and perform thousands of such ultrasounds-I live in Cagliari,Sardinia,Italy-and they do it in the orthodox (transabdominal) way,whilst I use the transvaginal.I had to argue a couple of times with the boss of this prenatal diagnosis center telling him that in my opinion,in a couple of cases,they measured the distance between the fetus'neck and the amnion instead of the proper nuchal translucency.As far as I remember,being in New York a few years ago attending a course held by S.Rottem and R.Snjders just before the Washington ISUOG,Nt measurements can be done both ways-and Rosalind was so utterly clear in explaining how things had to be done and the calipers put. So,the audit procedure should be performed more accurately by the FMF in order to avoid such errors and false positive Nt tests that only go to the detriment of this procedure. I must say,too,that I use Dr.Hutchon's calculator ever since it was introduced in Obgyn.net and it helped me (and my patients) immensely. Andrea Corda MD >----- Original Message ----- From: Dr. Eric Deigan <ericdeigan@prodigy.net> To: Multiple recipients of list ULTRASOUND <ultrasound@mail.medispecialty.com> Sent: Monday, March 19, 2001 9:38 PM Subject: Nuchal translucency testing >This is a plea (or reminder) for anyone who uses programs off the Internet >to calculate Down syndrome risk based on nuchal translucency (such as those >by Dr. Hutchon): > >Please note that the accuracy of these programs depends entirely on the >accuracy of the nuchal translucency measurement. Dr. Hutchon's website >states "These calculations assume that the NT measurements are made using >the same protocol as the Fetal Medicine Foundation", as do the other >websites with these calculators. > >The reason that the Fetal Medicine Foundation does not make the software >generally available until someone has been certified to do the testing is >that there is a danger both to the individual patient in giving an improper >assessment of risk, and to the reputation and future of the test if it gets >introduced by people who do not use it correctly. > >While measuring a nuchal translucency may seem easy (and indeed for those >experience at ultrasound it is not usually difficult to learn), it is also >very easy to make mistakes in obtaining the right image and in measuring it. >Typically in sonography we are not used to a few fractions of a millimeter >making any significant difference to the outcome, but with nuchal >translucency it can make a huge difference. I help in teaching some of the >Nuchal Translucency courses. One series of images I use in my lectures >shows how a fetus with an NT of 1.6 mm can have it measured at anywhere from >1.0 to 3.2 mm (using the same image) if the calipers are not placed exactly >according to protocol. The risk that would be quoted to the patient would >be tremendously different across this range of measurements. Then there are >all the other potential errors that can be introduced by not having the >correct image plane to begin with. > >This is why strict adherence to the FMF protocol is essential. I have often >been asked about using slightly different techniques in NT measurement. >There would be nothing wrong with someone using a different method from what >the FMF uses, as long as they then first obtained data on thousands of >patients based on their method of measurement before using it for patient >management. > >Eric Deigan, M.D., FACOG, FRCSC >Carolina Perinatal Associates, PLLC >Cary, NC, USA > Next message: Andrea Corda: "R: 3D" Previous message: DuboseTerryJ@uams.edu: "Re: 3D"

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