Early Onset Preeclampsia Webinar
Learn about recent research in the field of preeclampsia screening and prevention during this webinar from NTD Eurofins Labs — presented by Jiri Sonek, MD, chairman of the board for the Fetal Medicine Foundation USA, and Terrence Hallahan, PhD, laboratory director of NTD Eurofins Labs.
Click here for a full list of NTD Eurofins’ publications
Nuchal Translucency (NT) and Nasal Bone Assessment
You must be NT accredited before you can send samples to NTD Eurofins labs.
Steps to NT and Nasal Bone Accreditation:
- Take a Course
Both the Fetal Medicine Foundation (FMF) and the Nuchal Translucency Quality Review Program (NTQR) offer the didactic course required for NT accreditation for a fee.
- Submit Images
Both the FMF and the NTQR require sonographic images to be submitted for approval. We recommend you host a practical session with three to four practice patients (eleven to thirteen weeks gestation) per sonographer being trained to obtain images.
- Get Equipment
Proper equipment is necessary for generating the images for submission. We recommend one ultrasound machine per one to two sonographers being trained at the practical session.
- Get Approval
Both the FMF and the NTQR require you upload your images for approval. The FMF requires three images and the NTQR requires five images. Once approved, they will provide you with a certificate for measure NT and nasal bone assessment.
- Fax Accreditation Certificate
Once approved, your NT Certificate must be on file at NTD Eurofins, LLC. before submitting patient samples. Please include your NTD Eurofins, LLC. Account # and fax your certificate to 631-425-0864.
- Send Samples
Contact your local NTD Eurofins, LLC. Representative to in-service your staff on the correct process for sending samples to NTD Eurofins, LLC.
Uterine Artery Doppler (UtAD)
NTD Eurofins supports appropriate training and accreditation of sonographers and physicians for measuring uterine artery Doppler pulsatility index (UtAD-PI). UtAD-PI measurement is not required for PreeclampsiaScreen | T1. However, the addition of this measurement, increases the detection rate.
The Fetal Medicine Foundation (FMF) USA offers a program of education, accreditation, and ongoing quality assurance for those who wish to obtain their UtAD-PI accreditation. For more information and to sign up for the course, please visit http://www.fetalmedicineusa.com/pescreening.php and scroll down to the section on Uterine Artery Doppler.
Steps to UtAD Accreditation:
- Complete the FMF USA online 11-13+6 Weeks Scan Course for Medical Practitioners, if you have not already done so.
- Submit three images to FMF USA, all showing measurement of the UtAD-PI as well as the 2D plus color flow Doppler and pulsed Doppler gate placement. There is a one-time fee associated with film submission (if you have already paid this one-time fee to the FMF USA at any time, you do not need to pay again). Once the images are approved, the FMF USA will send a certificate for measuring uterine artery Doppler and you will be listed on the FMF USA weblist of Accredited Sonographers at http://fetalmedicineusa.com.
Mean Arterial Pressure (MAP)
Measurement of mean arterial pressure (MAP) at 11 weeks, 0 days – 13 weeks, 6 days’ gestation can be useful as an added biophysical marker for accurate risk assessment of early onset preeclampsia. The patient’s blood pressure should be taken using automated blood pressure devices that are calibrated at regular intervals.
Steps to obtain an accurate MAP measurement:
- Instruct the patient to sit without crossing her legs and with her arms supported at the level of her heart (e.g., on armrests). See Figure 1.
- Select an appropriate cuff size depending on the mid-arm circumference (small = 22-26 cm or 8.7-10.2 inches; regular = 27-34 cm or 10.6-13.4 inches; large = 35-44 cm or 13.8-17.3 inches).
- After the patient has been at rest for 5 minutes, measure blood pressure in both arms simultaneously. A series of recordings at 1-minute intervals should be taken until readings become stable-i.e., when the difference in systolic blood pressure is less than 10 mmHg and the difference in diastolic blood pressure is less than 6 mmHg between consecutive readings in each arm.
- Calculate the MAP by first figuring the average of the last two stable measurements of each arm. The measurement from the arm with the higher final pressure should be used for risk assessment by plugging it into the formula below, which results in one number (units in mmHg).
Click here to view Genetic Education Modules provided by the Perinatal Quality Foundation.
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