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Downs, Edwards & Pataus Screening Protocol (CG481)

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Downs, Edwards & Pataus Screening Protocol (CG481) Down’s, Edwards’ and Pataus syndromes screening protocol (CG481) Approval and Authorisation Approval Group Job Title, Chair of Committee Date Maternity Clinical Governance Chair, Maternity Clinical 4th June 2021 Committee Governance Committee Change History Version Date Author, job title Reason 8.0 Mar 2018 Jo Young, AN screening Reviewed and updated to reflect coordinator current practice 8.1 February J Young, AN screening Live change to update reporting 2019 coordinator body to PHE FASP and adjust working practices in line with this change. 8.2 August J Young, AN screening Live change following PHE Audit 2019 coordinator July 2019 Pg 6 – 5.5 The Combined Test gestation period in which NT scan can take place updated to read 11+2 and 14+1 weeks 9.0 March 2020 J Young, AN screening Reviewed, changes throughout to coordinator reflect current practice pg 5 – 16 and introduction of new MATSOP039 and update of consent form 10.0 May 2021 S Lindsay-Birch, ANNB Live change to reflect process post Screening Specialist MW Go Live and introduction of NIPT from 1/6/21 ................................................................................................................................................................... This protocol should be read in conjunction with the following: • Antenatal Screening protocol (CG474) • MAT-SOP-039 NT daily failsafe (WBCH only) Author: S Lindsay-Birch Date: June 2021 Job Title: ANNB Screening Specialist MW Review Date: June 2023 Policy Lead: Group Director Urgent Care Version: V10.0 Location: Policy hub/ Clinical/ Maternity/ Antenatal/ CG481 This document is valid only on date last printed Page 1 of 19 Maternity guidelines – Downs, Edwards & Pataus syndromes screening protocol (CG481) June 2021 Contents 1.0 Purpose .............................................................. Error! Bookmark not defined. 2.0 Scope ............................................................................................................. 3 3.0 Roles and Responsibilities .......................................................................... 3 4.0 Definitions ..................................................................................................... 4 5.0 Content .......................................................................................................... 5 5.1 The offer of screening .................................................................................. 5 5.2 Written information for Women ................................................................... 5 5.3 Booking the scan appointment ................................................................... 6 5.4 Late Bookers ................................................................................................. 6 5.5 The Combined Test....................................................................................... 6 5.6 NT greater than or equal to 3.5mm .............................................................. 6 5.7 Bloods - Reading .......................................................................................... 7 5.8 Bloods - Newbury ......................................................................................... 7 5.9 Multiple Pregnancy ....................................................................................... 8 5.10 The Quadruple Test ...................................................................................... 8 5.11 Test Results .................................................................................................. 8 5.12 Non-Invasive Prenatal Testing (NIPT) ......................................................... 9 5.11.1 Eligibility - Inclusions .................................................................................. 9 5.11.2 Eligibility - Exclusions ............................................................................... 10 5.11.3 Eligibility Uncertain criteria ....................................................................... 10 5.13 Failsafe’s ..................................................................................................... 11 5.14 Test Results: Low PAPP-A ......................................................................... 12 5.15 NIPT results ................................................................................................. 12 5.15.1 Managing NIPT results ............................................................................... 13 5.15.2 Giving results to women ............................................................................ 13 5.16 Prenatal diagnosis (PND) ........................................................................... 14 5.17 Education and training ............................................................................... 14 5.18 Audit and QA Requirements ...................................................................... 14 5.19 Unexpected Down’s, Edwards’ or Patau’s Live Births following Low Chance Screening ...................................................................................... 15 5.20 Suspected Screening Incidents ................................................................. 15 6.0 Local Contacts ............................................................................................ 16 7.0 Consultation ................................................................................................ 16 8.0 Dissemination/Circulation .......................................................................... 16 9.0 References .................................................................................................. 17 10.0 Auditable standards: .................................................................................. 17 11.0 Implementation ........................................................................................... 17 12.0 Training ........................................................................................................ 17 Author: S Lindsay-Birch Date: June 2021 Job Title: ANNB Screening Specialist MW Review Date: June 2023 Policy Lead: Group Director Urgent Care Version: V10.0 Location: Policy hub/ Clinical/ Maternity/ Antenatal/ CG481 This document is valid only on date last printed Page 2 of 19 Maternity guidelines – Downs, Edwards & Pataus syndromes screening protocol (CG481) June 2021 1.0 Purpose Public Health England (PHE) Fetal Anomaly Screening Programme (FASP) recommends that all women booking for antenatal care before 20 weeks’ gestation should be offered screening for Down’s, Edwards and Pataus syndromes. All Trusts work to the standards. 2.0 Scope To outline the procedures and working practices for Down’s, Edward’s and Patau’s syndrome screening, ensuring that the following aims are achieved: 1. To offer screening and diagnosis to all women booked before 20 weeks of pregnancy and attending for antenatal care within the booked cohort of the Royal Berkshire NHS Foundation Trust Maternity Services 2. To provide adequate high quality information on the screening process to support each woman to make an informed decision on whether to accept or decline the offer of screening. 3. To provide adequate information and support to enable the woman and her partner to make a decision on the outcome of the pregnancy. 4. For women with a confirmed diagnosis or in the event of positive NIPT following additional testing as a result of screening, who choose to continue the pregnancy, provide optimal management of the pregnancy, birth and newborn period. 5. For women with a confirmed diagnosis following additional testing as a result of screening who opt for termination of pregnancy to provide the optimal care and support including signposting to bereavement counseling 3.0 Roles and Responsibilities 3.1 Trust Antenatal and Newborn Screening Committee The Trust Antenatal and Newborn Screening Committee will: • Ensure that PHE FASP standards are implemented locally • Monitor compliance with Key Performance Indicators (KPIs) • Ensure audits against standards are completed. Facilitate and advise on all local policies, protocols and guidelines to be implemented into practice 3.2 Antenatal and Newborn Screening Co-ordinators The screening co-ordinators will: • Ensure local policies, protocols and guidelines for antenatal and newborn screening are in place • Ensure that failsafe systems are in place to ensure robust service provision. • Ensure that training on antenatal and newborn screening is available for all appropriate staff Author: S Lindsay-Birch Date: June 2021 Job Title: ANNB Screening Specialist MW Review Date: June 2023 Policy Lead: Group Director Urgent Care Version: V10.0 Location: Policy hub/ Clinical/ Maternity/ Antenatal/ CG481 This document is valid only on date last printed Page 3 of 19 Maternity guidelines – Downs, Edwards & Pataus syndromes screening protocol (CG481) June 2021 • Ensure quarterly Screening KPIs are reported in a timely manner • Produce an annual report 3.3 Matrons The Matron for community and midwifery led services and the Matron for Hospital Service will: • Ensure that all midwifery staff have access to training on antenatal and newborn screening • Ensure that all local policies, protocols and guidelines are implemented into practice • Ensure that remedial actions are taken when KPIs fall below the expected standards 3.4 Individual Staff Members Staff will • Ensure their knowledge and skills on antenatal and newborn screening are regularly updated • Ensure that they provide all women with information to enable informed choice on screening
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