Implementation of an NHS First Trimester Screening Clinic

Abstract

We aimed to improve trisomy 21 and maternal screening by introducing a 'one-stop' NHS first trimester screening clinic (FTSC). We offered first trimester ultrasound assessment of nuchal translucency (NT), measurement of serum free βHCG and Papp-A, along with maternal screening tests (full blood count, rubella, hepatitis B, syphilis, HIV and midstream urine culture). We restructured antenatal clinics, developed clear algorithms, provided detailed patient information and consent leaflets, ensured high standards of ultrasound and serum biochemistry measurement. After one year, completion of screening improved (60–91%) whilst maintaining a high trisomy 21 detection rate (89%) along with a 23% reduction in number of invasive procedures. A reliable FTSC can be introduced which complements existing NHS maternity care.