About the quality improvements
Screening for Down syndrome and other conditions has been available in New Zealand for some years. The new screening options available improve the quality and safety of screening services for pregnant women who choose to have screening.
In June 2005 the National Screening Unit (NSU) commissioned Professor Peter Stone and Diana Austin to assess antenatal screening for Down syndrome in New Zealand. As part of their work, Stone and Austin:
- reviewed the literature and best practice for antenatal screening for Down syndrome
- assessed current practice in New Zealand
- discussed issues for implementing a New Zealand screening programme, based on the research into current practice and the views of health practitioners and consumers
- surveyed and collated information on screening for Down syndrome that could be used in a New Zealand context (Stone and Austin 2006).
Following on from this report, the NSU established the Antenatal Down Syndrome Screening Advisory Group to provide technical and strategic advice on the appropriateness and feasibility of a national antenatal Down syndrome screening programme in New Zealand. In particular, the Advisory Group was asked to provide advice on:
- interim steps to improve the access, safety and quality of existing antenatal screening for Down syndrome
- the applicability of the National Health Committee’s criteria to assess an antenatal Down syndrome screening programme
- the need for and acceptability of a nationally organised antenatal Down syndrome screening programme.
The Report’s recommendations
The report released in April 2007 by the National Screening Unit, Antenatal Down Syndrome Screening in New Zealand 2007, identified that the practice of screening using maternal age and/or nuchal translucency (NT) without biochemical markers was unsafe and should not continue. They recommended that a process of development and introduction of quality improvements to available screening in New Zealand should be implemented.
What has happened since then
NSU has introduced two new options for screening for Down syndrome and other conditions.
- The first is First Trimester Combined Screening, available for women who would like to have screening and are less than 14 weeks pregnant. This screen requires both a blood test and a scan.
- The second option ‘Second Trimester Maternal Serum Screening’ is available for women who are between 14 and 20 weeks pregnant. This requires a blood test.
Both screens are funded by the Ministry of Health but some ultrasound (scan) providers charge an additional fee on top of the government funding.
The NSU also developed and published updated information for women about screening. They also developed and published guidelines and education for practitioners so as to ensure that they were able to give women consistent and up-to-date information when discussing screening.