Pathway for Trisomy 21 screening

(1st trimester) Screening Programmes

Fetal Anomaly

Offer verbal and written information (Screening Tests for You and Your Baby) about
dating scan, Trisomy 21 screening and 18+0 to 20+6 weeks fetal anomaly scan
At first contact visit or at booking visit with midwife

1st trimester combined screening (and dating scan)

Woman declines all screening offered to woman
(Screening time frame 10+0 to 13+6 weeks gestation)

Continue and obtain

pregnancy outcome Woman accepts all screening

Obtain consent
Record decision in hand-held notes*

NT3.5mm Dating scan, blood test and NT scan Ideally at the same visit
Inform clinican undertaken with maternal consent

Go to NT pathway Documentation
Complete request form Correct maternal demographics
Gestational age by ultrasound scan (CRL or HC)
NT measurement in mm
Smoker (yes/no), if yes, how many, date stopped
Maternal weight on day blood sample taken
Family origin/ancestry
Dispatch Diabetic (yes/no)
Sample and form to screening laboratory Single or multiple pregnancy
Fertility treatment (age of donor egg)

Arrival and validation

of sample and laboratory form by laboratory staff

Sample accepted for analysis

Laboratory analysis undertaken

Higher risk Lower risk

Record result in hand-held notes*

Communication of results from Inform woman
laboratory to midwife Prenatal diagnosis not offered
Colour key

First contact/booking Recall woman Continue and

Screening test Record in hand-held notes* obtain pregnancy
Discuss options outcome
Accepts Offer information on Trisomy 21
Declines Give information about prenatal diagnosis
Ultrasound
High risk
Woman declines Woman accepts
Low risk prenatal diagnosis prenatal diagnosis
Laboratory
Prenatal diagnosis
Continue and Go to
*This also includes reporting in an obtain pregnancy prenatal diagnosis
electronic auditable system outcome pathway