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The 11-13+6 Week Scan Course Series
The process of training for nuchal translucency screening consists of 1) Nuchal Translucency theoretical training 2) Nuchal Translucency practical assessment (Nuchal Translucency Practical Training course) and the ongoing audit.

All medical personnel involved in antenatal care using nuchal translucency ultrasound are invited to attend one of the Fetal Medicine International courses (live or internet) on the 11-13+6 week scan which will cover:

• The principles of prenatal genetic screening and diagnosis,
• Amniocentesis and chorionic villus sampling,
• Non-invasive screening for chromosome abnormalities:
• The 11-13+6 week scan
i. Nuchal Translucency and chromosome abnormalities,
ii. Increased Nuchal Translucency and normal karyotype,
iii. 1st and 2nd biochemical markers
• The standardized method for measurement of the nuchal translucency
• Multiple pregnancy.

The course content is supported by a book “The 11-13+6 Week Scan – The Diagnosis of Fetal Abnormalities” edited by KH Nicolaides and published by Parthenon Publishing. Click "http://fetalmedicine.com/pdf/11-14/english/FMF-English.pdf” to view. Note: you will need Adobe Acrobat Reader to view it. There is a multiple-choice examination at the end of this nuchal translucency training course which all participants are invited to take

The purpose of the nuchal translucency theory test is to ensure that candidates have understood the course content: the course book can be used for reference. Successful candidates will receive a certificate to acknowledge successful completion of the nuchal translucency theoretical component of the “Certificate in the 11-13+6 Week Scan”. Ultrasonographers are then eligible to undertake the nuchal translucency practical course (includes image submission for audit). Once the certificate of Nuchal Translucency training (Theoretical and Practical) is obtained, candidates (and the institution they work in) will be included in the Fetal Medicine Foundation of Canada’s (and Fetal Medicine Foundation UK) list of “Registered Nuchal Translucency Sonographers”.

TRAINING FOR SONOGRAPHERS/PHYSICIANS
1) COMPLETE NUCHAL TRANSLUCENCY THEORY COURSE
2) COMPLETE NUCHAL TRANSLUCENCY PRACTICAL COURSE
• ONLINE LECTURES
• NUCHAL TRANSLUCENCY IMAGE ASSESSMENT EXCERCISE
• NUCHAL TRANSLUCENCY IMAGE SUBMISSION FOR VISUAL INSPECTION

Upon completion of the Nuchal Translucency theoretical and Nuchal Translucency practical course, the candidate will receive a certificate confirming completion of the 11-13+6 week scan training. Each person will be assigned a personal ID code that identifies him/her as a trained sonographer in our Internet database.

ADDITIONAL TRAINING FOR PHYSICIANS
1)COMPLETE QUALITY ASSURANCE TUTORIAL COURSE
• ONLINE LECTURES
• TRANSLUCENCY NUCHAL IMAGE AUDIT EXERCISE AND EXAM

Physicians in a supervisory capacity are eligible to receive a QA certificate, provided they complete the Nuchal Translucency theoretical course and complete the online “Quality Assurance Tutorial course”. Please note the QA certificate does not entitle the individual to be eligible for risk-assessment software from Fetal Medicine Foundation UK.

NUCHAL TRANSLUCENCY SOFTWARE

The use of Nuchal Translucency scan or Nuchal Translucency scan + biochemistry to modify the woman’s risk for aneuploidy should be offered in the context of a coordinated screening program that provides counseling, risk assessment and appropriate follow-up. The software for combined risk assessment should include an audit function that allows the Nuchal Translucency medians (individuals and centers) to be tracked and evaluated on a regular basis by a quality assurance program.

In Ontario-Canada, efforts are being made to establish a provincial QA program. The risk-assessment software will reside in the provincial laboratories, and the Nuchal Translucency distributions of the sonographers will be tracked using the unique sonographer code number. There will be a requirement to send 5 images for visual audit on a yearly basis.

Outside of Ontario-Canada, candidates who complete the full training process by attending the Nuchal Translucency theoretical course as well as passing the Nuchal Translucency practical course, will be eligible to apply for the 11-13+6 week scan software for risk-adjustment (through Fetal Medicine Foundation UK). Please note that there is a charge of $50 Euros for licensing of the software. Further details are available through Fetal Medicine Foundation of Canada or Fetal Medicine Foundation. Compliance with yearly audit is a prerequisite for using this software.

IMAGE SUBMISSION FOR VISUAL INSPECTION

1) Register online for the Nuchal Translucency Practical Training Course

2) Follow instructions for image submission (online upload of Jpeg format images or by mail) after completion of online Nuchal Translucency practical course content.

3) How are the images assessed?

Each image will be audited according to the following 5 CRITERIA:
1) SAGITTAL VIEW (true sagittal section, not oblique)
2) HEAD POSITION (neutral, not flexed or extended)
3) MAGNIFICATION (only fetal head, neck and upper thorax on screen)
4) AREA OF MEASUREMENT (widest point of NT)
5) CALIPER POSITION (on borders of the translucency)

The image is considered satisfactory if all 5 criteria are met.

4) What are the criteria for a successful Nuchal Translucency image audit?

Your Nuchal translucency image audit will be considered successful if all these criteria are fulfilled in at least at least 8 of the 10 Nuchal translucency images.

5) What will be recommended if I do not pass the Nuchal Translucency image audit?

IMAGE ASSESSMENT RECOMMENDATION
3-4 unsatisfactory images Send 5 more images
> 4 unsatisfactory images Send 10 more

CONTACT ADDRESSES AND PHONE NUMBERS

Fetal Medicine Foundation of Canada
255 Consumers Road, Suite 500
Toronto, ON M2J 1R4
Canada

Tel: (647) 822-7704
Email: fetalmedicinecanada@gmail.com