News and updates
February 14, 2025
NT ultrasound following Non-Invasive Prenatal Testing (NIPT)
If NIPT is initiated as a primary screening test, a stand-alone 11-14 week (NT) ultrasound is recommended. Other screening tests (e.g. eFTS) are not generally recommended given that NIPT is more accurate.
Although the patient is not eligible for First Trimester Screening (FTS), we recommend completing the Maternal Multiple Serum (MMS) requisition if provided by the ordering practitioner and advising the patient to proceed with the blood draw. All determinations regarding testing and gestational age will be made at the laboratory level. Sonographers should refrain from informing the patient that FTS is unnecessary, as providing guidance on prenatal genetic screening falls outside their scope of practice. Once the blood sample and requisition form are received, the MMS laboratory will communicate the results to the ordering practitioner.
Recertification Requirements
NT operators submit variable quantities of NT data to the Ontario MMS labs depending on the volume of first trimester screening ultrasounds performed. With the high level of skill and experience required for nuchal translucency measurements, a standard recertification process is required for NT operators who have completed zero NT ultrasounds and submitted no data to the Ontario MMS labs for three (3) consecutive years. During the recertification period, sonographers’ NT identification numbers are temporarily suspended. Please contact sburnettroy@BORNOntario.ca for further information.
September 12, 2024
Guide on completing the Multiple Marker Screening requisition
A guide on how to correctly complete the requisition in various scenarios for singleton and twin pregnancies is now available in PDF format that you can print for a quick reference. Remember that providing incorrect or missing information can delay the patient's risk assessment or affect the accuracy of the calculation.
July 23, 2024
Nuchal Translucency, Cystic Hygroma, and Nuchal Fold – What Are the Differences?
Nuchal Translucency
Definition: NT refers to a small, thin hypoechoic space seen in the posterior fetal neck during the first trimester ultrasound. NT is a normal structure where size measurement is used as a risk factor for genetic disorders.Significance: Enlarged NT(≥ 3.5 mm ) is associated with an increased risk of anatomic abnormalities (especially cardiac anomalies), chromosomal and genetic abnormalities (such as Down syndrome), and other adverse outcomes.
Cystic Hygroma
Definition: Cystic hygroma is usually seen as a large single or multilocular fluid-filled cavity located in the nuchal region, behind and around the fetal neck, which can extend the length of the fetus and can be seen on 1st trimester fetal ultrasound.
Cause: It often results from abnormalities in the lymphatic system.
Differentiation: Cystic hygroma is not a normal structure. It is usually larger than 3.5 mm (definition of enlarged NT), but occasionally it is difficult to differentiate a cystic hygroma from an enlarged NT, when there are septations seen.
Significance: It has a higher risk for aneuploidy, cardiac anomalies and fetal demise when compared to NT.
Nuchal Fold
Definition: The nuchal fold is a normal fold of skin observed at the back of the fetal neck during the second trimester of pregnancy.
Measurement: The nuchal fold (NF) thickness is the distance from the outer edge of the occipital bone to the outer edge of the skin in axial section through the head at the level of the thalami, cavum septi pellucidi, and cerebellar hemispheres.
Significance: Increased thickness of the nuchal fold (≥ 6mm between 15 and 20 weeks of gestation) is considered a soft marker for Trisomy 21.
References:
- Nuchal translucency | Radiology Reference Article | Radiopaedia.org
- Cystic Hygroma: Definition, Genetics and Prognosis
- Second Trimester Nuchal Fold - What Does It Mean? - The ObG Project
- No. 348-Joint SOGC-CCMG Guideline: Update on Prenatal Screening for Fetal Aneuploidy, Fetal Anomalies, and Adverse Pregnancy Outcomes (ccmg-ccgm.org)
May 3, 2024
Key facts about dating a pregnancy using Crown-Rump Length
- First trimester crown−rump length (CRL) is the best parameter for determination of gestational age in all pregnancies except those conceived by in vitro fertilization, which should be based on fertilization date.
- The earliest ultrasound with a crown−rump length equivalent to at least 7 weeks (or 10 mm) shall be used to determine the gestational age1.
- Based on the Southern Ontario Obstetrical Network Consensus statement, the CRL Chart published by Daya et al.2 shall be used for determination of gestational age.
1Butt, K., & Lim, K. I. (2019). Guideline no. 388-determination of gestational age by ultrasound. Journal of Obstetrics and Gynaecology Canada, 41(10), 1497–1507.
2Daya, S. (1993). Accuracy of gestational age estimation by means of fetal crown-rump length measurement. American Journal of Obstetrics and Gynecology, 168(3), 903–908.
October 12, 2023
The nuchal translucency ultrasound - what it means for pregnant individuals
The power of this specialized ultrasound is explained by surgeon/sonologist Dr Mathew Lenoardi in an article for Empowering Women's Health. Please note that the timeframe for the nuchal translucency ultrasound is 11 weeks 2 days to 13 weeks 3 days, not 11 weeks 5 days to 13 weeks 6 days as indicated in the article.
Sept 18, 2023
Get proof of registration for employment
Many employers now request that sonographers are registered in the NTQA program. The statement "As of today’s date, dd-mmm-yyyy, Sonographer code XXXXX is currently registered as an active Nuchal Translucency Sonographer by the Ontario Multiple Marker Screening (MMS) Laboratories." has been added to the individual NT curve of active sonographers. Log into BIS, review your personalized NT performance distribution curve and take a screenshot to provide proof of registration to employers.
BORN has extended its password expiry duration to one year
This change means that you will be prompted to reset your password on an annual basis, instead of every 90 days. This password expiration duration change will take effect for each user after their next password change.
Subscribe to this page