In August of 2006, PCRM launched First Trimester Screening. Since its inception in the early 90s, FTS has become widely accepted throughout the world as a highly effective form of prenatal screening.  Our FTS program uses a combination of ultrasound and blood work to determine risks of chromosome abnormalities in a non-invasive way.  Although Nuchal Translucency (NT) is growing in popularity in North America, NT is only one part of the First Trimester Screen, and should not be taken alone without the other markers of genetics.

Over 45 countries now perform FTS, and the leaders in the field of screening span from the UK, through Europe, Israel, Australia/New Zealand and the far east.   The most up-to-date version of FTS looks at:

Nuchal Transluceny (NT)
Nasal Bone Determination (NB)
Fetal Heart Rate (FHR)
Ductus Venosus Flow (DV)
Measurement of free beta hCG and PAPP-A (blood work)

The ultrasound also assesses early fetal anatomy, amniotic fluid, placental location, and confirms the due date.  When information from the ultrasound and blood work is combined, the detection rate for genetic syndromes is above 96%, with a 3% false positive risk.  This is by far the most accurate way to predict risk, in a safe and non-invasive way. 

The Fetal Medicine Foundation, directed by Professor Kypros Nicolaides, is the pioneering leader of first trimester screening (www.fetalmedicine.com).  Based in the United Kingdom, the Fetal Medicine Foundation is the over-seeing board which accredits and audits screening locations globally.  PCRM is a certified site of the Fetal Medicine Foundation. Dr. Seethram is certified to perform both the NT, NB and DV determinations.  PCRM uses the Fetal Medicine Foundation Risk Reporting software and our on-site maternal biochemistry lab is equipped with the Delfia Xpress system (Finland), a global leader in serum screening.

What to expect at your appointments?

FTS is performed any time between the 11th week and the end of the 13th week.  The screening is usually arranged in two appointments, a protocol called a two-stage OSCAR.  The first appointment, generally scheduled in the 10-11th week, is for the blood work. This appointment takes about 15 minutes. No preparation for the blood work is required, so feel free to eat and drink as you normally would.

The second appointment includes a consultation and ultrasound by Dr. Seethram. Immediately after the ultrasound, results are given to you by Ursula Durland, our genetic counselor.  This appointment generally is scheduled after the 11th week and takes about an hour. All we ask is that you are well-hydrated; a full bladder is NOT required.   That same day, the written report will be sent to your health care provider. Patients are encouraged to bring their partner or a close friend.

Definitions

• Nuchal Translucency
  This is the measurement of fluid between the spine and the skin of the fetal neck, done best at 11-14 weeks.
• Nasal Bone
  This is the ultrasound determination of calcium in the nasal cartilage.
• Ductus Venosus
  This is the measurement of blood flow through a small vessel in the fetal liver.
• hCG
  Is a protein made by the placenta which can go up or down in genetic syndromes and other conditions.
• PAPP-A
  Is another protein made by the placenta and the fetus

PCRM’s First Trimester Screening program is available to all expecting mothers.  Both the blood work and ultrasound are unique to FTS; they are not covered by MSP.  We also encourage referrals from your family physician, obstetrician, or midwife.  We ensure prompt communication of your results to them.

For more information, or to speak with Dr. Seethram or Ursula Durland, please call 604.422.7276.