fetal anomaly screening programme

Last reviewed 01/2018

Key messages from NHS Fetal Anomaly Screening Programme:

• All pregnant women in England should be offered fetal anomaly screening
• Screening is optional
• Consent should be obtained, by the person making the referral for the scan, before the referral is made
• Dating scans should take place after 8 weeks and before 14 weeks and 1 days gestation
• Anomaly scans should take place between 18 weeks 0 days and 20 weeks and 6 days
• Women should be aware of the limitations of ultrasound scans o Anomalies can be seen on any ultrasound scan
• http://fetalanomaly.screening.nhs.uk/

• All women should be offered a minimum of two ultrasound scans during pregnancy. At the first antenatal appointment women should be offered an early ultrasound scan for gestational age assessment. This scan should ideally take place between 11 weeks and 0 days and 14 weeks and 1 day
  
  
• Ultrasound screening for fetal anomalies should be routinely offered, normally between 18 weeks and 0 days and 20 weeks and 6 days (1). " The overall timeline for pregnancy chromosomal screening (test) and the laboratory risk calculation is from 10 weeks + 0 days to 20 weeks + 0 days of pregnancy
  
  
• At the first contact with a healthcare professional, women should be given information about the purpose and implications of the anomaly scan to enable them to make an informed choice as to whether or not to have the scan
  
  
  
• The objectives of the 18+0 to 20+6 days ultrasound scan is to:-
  • Ensure access to a uniform screening programme which conforms to an agreed level of quality
  • Provide appropriate information for women so that they are able to make an informed choice
    • Offer choices to women about their screening options and pregnancy management Identify serious fetal abnormalities, either incompatible with life or associated with morbidity, allowing women to make reproductive choices
  • Identify certain abnormalities that may benefit from antenatal intervention
  • Identify certain abnormalities that require early intervention following delivery
    
    
• These objectives adhere to the "NHS Fetal Anomaly Screening Programme 18+0 to 20+6 Weeks Fetal Anomaly Scan National Standards and Guidance for England"
  
  
• Women should be informed of the limitations of routine ultrasound screening and that detection rates vary by the type of fetal anomaly, the woman's body mass index and the position of the unborn baby at the time of the scan
  
  
• If an anomaly is detected during the anomaly scan pregnant women should be informed of the findings to enable them to make an informed choice as to whether they wish to continue with the pregnancy or have a termination of pregnancy
  
  
• Fetal echocardiography involving the four-chamber view of the fetal heart and outflow tracts is recommended as part of the routine anomaly scan
  
  
• Routine screening for cardiac anomalies using nuchal translucency is not recommended
  
  
• When routine ultrasound screening is performed to detect neural tube defects, alpha-fetoprotein testing is not required

The Fetal Anomaly screening programme has working groups looking at standards, and education and training. Further information on all above aspects is available here: www.fetalanomaly.screening.nhs.uk

Reference:

• NICE (March 2016). Antenatal care for uncomplicated pregnancies
• NHS Fetal Anomaly Screening Programme. Antenatal screening - working standards for Down's syndrome screening 2007. NHS FASP; 2007.
• NHS Fetal Anomaly Screening Programme. Consent standards for screening fetal anomalies during pregnancy 2007. NHS FASP; 2007.
• NHS Fetal Anomaly Screening Programme. NHS fetal Anomaly screening programme - screening for Down's syndrome: UK NSC Policy recommendations 2007-2010: Model of Best Practice. Department of Health; 2008.
• Kirwan D, NHS FASP. 18+0 to 20+6 weeks fetal anomaly scan -National standards and guidance for England 2010. Exeter, England: NHS Fetal Anomaly Screening Programme; 2010.