A report released in April 2007 by the National Screening Unit, Antenatal Down Syndrome Screening in New Zealand 2007, is the result of work carried out by the Antenatal Down Syndrome Screening Advisory Group, which was convened as part of a review of the current practice of antenatal screening for Down syndrome undertaken by the National Screening Unit.

The Advisory Group unanimously agreed that the current practice of screening using only maternal age and/or nuchal translucency (NT), without biochemical markers is unsafe, inequitable, and should not continue. It said current screening methods commonly used are not as reliable and accurate as other methods that are available. This results in too many women having diagnostic tests, and as these have a small risk of miscarriage (about 1 to 2 percent). The Advisory Group made a number of recommendations for ways to improve the safety and quality for antenatal Down syndrome screening.

Following the stakeholder workshops in mid 2007 the Ministry of Health has undertaken detailed implementation planning to ensure the quality improvement of current screening.  In late 2007 the government agreed to fund improvements to the quality of screening for Down syndrome.  The purpose of these quality improvements is to ensure that women who choose to have screening will be able to access the safest and most reliable form of screening available.  Women who choose not to be screened will be supported in their decision.

The initial measure will be the funding of the second trimester maternal serum test from August 2008.  This is to improve the access to screening and is primarily for women who have not had a nuchal translucency (NT) scan or who choose to wait for a combined result with their NT scan and arrange this with their ultrasound practitioner.

Other quality improvements which will be implemented by mid 2009 will include the development of:

• a range of screening tests/pathway options that can be accessed by women who present in the first and/or second trimester
• information for pregnant women and their partners
• information and standards for practitioners on appropriate screening tests and protocols
• standards for ultrasound services and laboratories
• improved access to counselling, support services and genetic services
• monitoring of laboratories, ultrasound services and pregnancy care providers.

The National Screening Unit will plan, coordinate and monitor these quality improvements with expert advice from key groups and organisations from the health and disability sector.  Please feel welcome to contact Nicola Deveraux, Programme Manager Antenatal Screening, on (09) 580 9243 or email nicola_deveraux@moh.govt.nz if you would like to discuss this in more detail.