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PM.45 Increased NT – a Retrospective Audit from a University Hospital
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  1. G Holding,
  2. NK Vanes,
  3. S Mukherjee
  1. UHCW, Coventry, Coventry, UK

Abstract

The Aim of this audit was to ensure that our teaching hospital was continuing to provide good quality care for women who were screened and presented with increased nuchal translucency (NT) >3.5 mm. We had initial difficulty identifying these women.

We identified 54 women with an NT greater than 3.5 mm. The NT mean ± SD was 5.5 ± 1.9. Of these 46/54 (85%) agreed to an invasive test. Two women were referred to the regional fetal medicine department. Therefore 44 women underwent invasive testing within our department. Mean gestation age was 13 weeks for chorionic villous sampling and 17 weeks for amniocentesis.

All 44 were performed using ultrasound guidance using a 19 or 20 G needle. There was one failed attempt in those undergoing CVS and one with amniocentesis. There were no miscarriages in these women undergoing invasive testing. Five women required anti D and all received it. None of those undergoing testing had a bloody tap or post procedure infection.

Twelve fetuses had abnormal karotypes with trisomy 13 (n = 2), trisomy 18 (n = 4), trisomy 21 (n = 4) and Turners (n = 2). Of these 8 underwent termination of pregnancy, with 3 women going to term with trisomy 21 and 1 with trisomy 13.

Despite our unit achieving 100% compliance with the standards set by the Green-top guideline No8 Amniocentesis and CVS, there was initial difficulty in identifying those with abnormal screening results. As a result of this audit, a computerised logbook of all procedures has been created to help with future auditing.

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