NT Quality Assurance

The Nuchal Translucency Quality Assurance (NTQA) program defines the requirements for NT registration in Ontario and provides the tools for supporting sonographers performing NT measurements for Multiple Marker Screening.

Role of NT in Multiple Marker Screening (MMS)

The fetal nuchal translucency (NT) is a collection of fluid that is present at the back of the fetal neck in the first trimester of pregnancy. An increased NT measurement can be a normal variant, but is associated with a higher chance for chromosome differences, cardiac defects and other conditions.

A sonographer or physician measures the thickness of the fetal NT when the fetal crown rump length (CRL) is between 45mm and 84mm (approximately 11 ̶ 14 weeks gestation). If the pregnant individual is having enhanced First Trimester Screening (eFTS) or screening for vanishing twins/co-twin demise, this NT measurement is submitted to one of the three Ontario MMS laboratories along with a blood sample. The laboratories use this measurement along with clinical information and biochemical serum markers to calculate the individual chance for a pregnancy to have trisomy 21 (Down Syndrome) or trisomy 18. The NT measurement is the most heavily weighted factor in this equation.

Visit the Fetal Medicine Foundation (FMF UK) website for more information about the fetal NT, the relationship between the NT measurement and prenatal screening, and the diagnostic requirements of NT ultrasound.

Importance of a NTQA Program

Since the incorporation of the NT measurement into the prenatal screening process, sonographers have played a significant role in providing excellent quality risk assessment for trisomy 21 (Down syndrome) and trisomy 18.

Both international and national professional bodies recommend that sonographers participate in a formal NT Quality Assurance (NTQA) program if taking NT measurements. Without participation in such a program, measurement and screening quality deteriorates over time.

Ontario's NTQA Program

Prenatal Screening Ontario (PSO), a program housed within BORN Ontario, has been given the mandate to coordinate prenatal screening in the province including supporting the quality assurance of NT ultrasound when it is incorporated with Multiple Marker Screening.

Registration with the NTQA program has many benefits. It will allow you, as a sonographer or physician, to perform nuchal translucency (NT) measurements for Multiple Marker Screening tests, such as enhanced First Trimester Screening (eFTS). It will also allow you compare your NT measurement performance against international standards and obtain support to improve or maintain the quality of your scanning.

Get your registration started

Your other team members

Physicians who report but do not scan NT ultrasounds, do not require an Ontario NT ID number. PSO recommends that these physicians complete the Fetal Medicine Foundation (FMF) 11-13 weeks scan course to refresh their knowledge on proper NT measurement protocol. They should also ensure that sonographers are complying with the expectations of Ontario's NTQA program.

Quality advisors or medical directors who oversee sonographers performing NTs are recommended to sign up to receive communications regarding Ontario's NTQA program.

Registration for quality advisors or medical directors

Governance

PSO / BORN Ontario works with different partners to support high-quality NT measurements for Multiple Marker Screening.

PSO / BORN Ontario

Prenatal Screening Ontario (PSO) / BORN Ontario coordinates the NT Quality Assurance (NTQA) program and provides support to sonographers for their NT scanning practice. We also supply data analysis and sonographer NT-audit reports. We do not hold authority over whether an individual sonographer should or should not perform NT ultrasound for the purpose of MMS.

MMS Laboratories

Ontario Multiple Marker Screening (MMS) laboratories are responsible for the quality of the MMS and resulting screening reports, including the incorporation of sonographers' NT measurements. The labs, as a collective group, hold the authority to decide whether an individual sonographer should or should not provide NT measurements for the purpose of MMS.

CMIRTO

College of Medical Radiation and Imaging Technologists of Ontario (CMRITO) is a regulatory body for medical radiation and imaging technologists in Ontario. CMRITO protects public interest by ensuring diagnostic medical sonographers are qualified and practicing professionally. Does not require any specific education or certification for members to practice in the areas of specialization such as NT scanning.

About the Nuchal Translucency Quality Assurance (NTQA) program

Role of NT in Multiple Marker Screening (MMS)

Importance of a NTQA Program

Ontario's NTQA Program

Your other team members

Governance

Contact Us