News & Events
09/09/11: Down’s syndrome screening offered in routine antenatal care
18/04/11: Welsh Study of Mothers and Babies
21/06/10: Antenatal Screening Wales pathways published on the Map of Medicine
08/06/10: The Antenatal Screening Wales ‘information for women’ packs have been updated
01/05/10: Welsh Study of Mothers and Babies
01/05/10: Wales Antenatal Screening Training Needs Analysis (TNA)
01/05/10: Fetal anomaly ultrasound menu
01/05/10: Review of the Antenatal Screening Wales local multiprofessional management groups
Down’s syndrome screening offered in routine antenatal care
Following recommendations from the UK National Screening Committee, the Minister has asked that the ‘combined test’ for Down’s syndrome should be offered to women attending for antenatal care in early pregnancy. At present, Down’s syndrome screening is offered in mid pregnancy (between 15 and 18 weeks).
Public Health Wales and the Health Boards have been asked to work together on implementing the change.
The Antenatal Screening Wales Down’s Syndrome and Fetal Anomaly group, which has membership from all key stakeholders, have met to discuss implementation issues. A report derived from the advice received at the meeting is being developed to help inform the planning of the next steps and discussions with Health Boards.
The ‘combined test’ requires an additional measurement to be taken as part of the early pregnancy dating scan and a blood test, usually on the same day as the ultrasound. Sonographers will require training before this can be implemented and this is being planned by Antenatal Screening Wales.
The change of test requires collaboration between Down’s syndrome screening and cytogenetic laboratories, ultrasound services and maternity services.
Rosemary Johnson, Programme Lead for Antenatal Screening Wales, said: “The introduction of the test needs to be managed to ensure the benefits of the ‘combined test’ are realised and that programme risks are minimised.
“A Project is being established by Antenatal Screening Wales to coordinate the all Wales elements of the implementation and to provide advice on local implementation.”
In addition, an improved mid-pregnancy test for Down’s Syndrome, known as the quadruple test, was introduced in Wales on 1 April 2011.
The test has been introduced in line with the UK National Screening Committee’s Model of Best Practice for Down’s syndrome screening, and replaces the triple test, a blood test previously carried out in the second trimester of pregnancy.
Rosemary Johnson added: “The quadruple test should slightly improve the screening programme detection rate and reduce the screen positive rate. This means less women will be offered an amniocentesis following the screening test.
“This test will still need to be available after combined screening is introduced, to ensure there is a Down’s syndrome test available for women who first attend antenatal care after 14 weeks of pregnancy.”
Welsh Study of Mothers and Babies
The recruitment stage of the Welsh Study of Mothers and Babies is complete. We have recruited the targeted 29,000 women from across Wales to the study. Thank you to all who have helped in the recruitment of these women and in the handling of consent forms and questionnaires. We hope to have some initial findings from the study by October 2011.
Antenatal Screening Wales receives a commended prize at the 2010 BMA patient information awards
The awards were established in 1997 to recognize quality in written patient information leaflets and small booklets. It aims to encourage the production and dissemination of accessible, well-designed and clinically balanced materials which will enhance patients’ understanding of health issues.
Antenatal Screening Wales received a commended prize for their 'Information for Women' pack. The pack is in a question and answer format to divide up the text and aims to make the text more inviting to read.
Llywela Wilson, Regional Coordinator for Antenatal Screening Wales said; “We are delighted to receive the commended prize from the BMA patient information awards for our leaflets. We review our information packs annually to ensure they are up to date and reflect comments received from service users. It is extremely important that pregnant women receive the correct information in a clear and understandable format and it is gratifying that the BMA award recognizes our work on this.”
This follows on from the Antenatal Screening Wales 'Amniocentesis' leaflet being awarded a 'highly commended' prize in 2005 and the 'Chorionic Villus Sampling' leaflet being awarded a 'highly commended' prize in 2008.
Antenatal Screening Wales pathways published on the Map of Medicine
ASW have developed care pathways to support the Antenatal Screening Wales standards, and copies of these are published on the ‘Map of Medicine’.
The Map of Medicine is an internationally acknowledged resource, procured by Informing Healthcare, part of NHS Wales Informatics Service. The Map publishes national and local evidence based pathways on the internet and has a rigorous expert review and updating process.
Pathways give a rapid reference guide to the care that should be taken and can aid collaborative, consistent practices by giving on line access. Health professionals who wish to access any of the pathways will need to register as a user on the Map of Medicine.
There are links from the ASW Map of Medicine pathways to additional information, such as references, pathways for treatment, e.g. care of the HIV positive woman, and links to web sites with information about the conditions being screened.
The pathways on Map of Medicine have been developed on the NHS Wales view and each Health Board will have the opportunity to add information to the pathways to reflect local processes, e.g., the phone number for the local Sexual Health Clinics.
The nine pathways are:
- Amniocentesis and chorionic villus sampling
- Antenatal screening for blood group and antibodies
- Antenatal screening for Down’s syndrome
- Antenatal screening for HIV
- Antenatal screening for syphilis
- Antenatal screening for hepatitis B
- Antenatal screening for rubella susceptibility
- Antenatal screening for sickle cell and thalassaemia
- Antenatal ultrasound screening
The Antenatal Screening Wales ‘information for women’ packs have been updated
Although the cover looks the same, the information for women pack has been updated to reflect the recommended changes set out in the Revised Policy Standards and Protocols to support the provision of Antenatal Screening in Wales.
In line with guidance from the NHS Toolkit for producing patient information (2003), the information is now in a ‘question and answer’ format which recommends that this format is helpful to divide up text and aims to make the text more inviting to read.
The pack contains six leaflets: a basic summary information leaflet with an introduction to antenatal screening tests and five programme specific leaflets:
- Infections and pregnancy
- Screening for sickle cell and thalassaemia in pregnancy
- Ultrasound scans in pregnancy
- Screening for Down’s syndrome in pregnancy
- Your blood group and pregnancy
ASW provides the information pack to all maternity service in Wales for distribution to pregnant women. The information for women pack is available in the following languages: Arabic, Bengali, Cantonese, Czech, English, Gujarati, Hindi, Italian, Japanese, Mandarin, Nepalese, Polish, Portuguese, Punjabi, Somali, Turkish, Urdu and Welsh.
Copies of all the leaflets are available for downloading from this site or in hard copy from the Antenatal Screening Wales Office. For further information, please contact:
Ann-marie Donaghy
Antenatal Screening Wales
18 Cathedral Road
Cardiff
CF11 9LJ
Tel: 029 2078 7837
Revised Antenatal Screening Handbook for Midwives is published by Antenatal Screening Wales
A revised screening handbook for midwives providing antenatal screening has been published to support them in their role and provide a quick and easy reference to clinical information, screening pathways and voluntary sector contact details. Community midwives have limited access to the internet for this information in their daily consultations with women.
A review of the previous screening handbooks was undertaken with stakeholders in 2009 who indicated that the previous hardcopy A5 wirobound handbook was one of the most useful resource they had received from Antenatal Screening Wales.
All community midwives will be provided with a hardcopy of the handbook, which is being distributed in an information pack developed for the launch of the ‘Revised Policy, Standards and Protocols to Support the Provision of Antenatal Screening in Wales’.
The revised handbook includes information about:
- Communicable diseases i.e. HIV, Hepatitis B, Syphilis, Rubella
- Sickle cell and thalassaemia
- Down’s syndrome
- Blood group and antibodies
- and screening for these conditions in pregnancy.
Information is also provided about ultrasound scans in pregnancy. Basic screening pathways are included to clarify the next steps in the screening or diagnostic pathways.
Some information on the Newborn Hearing and Cervical Screening Programmes are also included as midwives may be asked for information on these programmes. For further information, please contact:
Ann-marie Donaghy
Antenatal Screening Wales
18 Cathedral Road
Cardiff
CF11 9LJ
Tel: 029 2078 7837
Revised policy standards and protocols to support the provision of Antenatal Screening in Wales
Revised Standards and Protocols have been the subject of public consultation and are a thorough revision and updating of the Antenatal Screening Wales Standards and Protocols published in December 2005. They build on the improvements achieved by the maternity, laboratory and genetics services since the 2005 publication.
A particular focus in this document is the requirement and recommended framework for adequate governance of the antenatal screening programme.
The document is available in English and Welsh on our policy and guidance page.
Welsh Study of Mothers and Babies
16,000 recruits so far We have now recruited 16,000 women into the study, which is just over half way there. Thank you!
Wales Antenatal Screening Training Needs Analysis (TNA)
Five hundred and nine health professionals (midwives, sonographers and doctors from across Wales) completed the communication skills questionnaire developed by ASW for this year’s TNA. The results will be available in June 2010. The results will highlight areas where education and training may be required and where the development of education products by ASW may be helpful.
Fetal anomaly ultrasound menu
The NSC Fetal Anomaly Screening Programme (NSC FASP) published the ‘18+0 to 20+6 Weeks Fetal Anomaly Scan National Standards and Guidance for England’ in January 2010. The document includes guidance on a number of aspects of the fetal anomaly scan including the structures which should be reported or ‘base menu’.
Wales established a ‘base menu’ in 2005 and this has now been reviewed in the light of the NSC FASP recommendations at two multiprofessionals meetings. A revised base menu for Wales will be agreed and a business case will be submitted to Health Solutions Wales detailing the changes required to the obstetric reporting module to enable reporting of the new menu.
Review of the Antenatal Screening Wales local multiprofessional management groups
Given the new structure of the NHS in Wales, ASW has reviewed its network structure and is exploring how best it can engage with new organisations. ASW has benefited from the support and experience offered by regular meetings with the multidisciplinary teams in the three very successful Local Multiprofessional Management Groups (LMMG) based on the geographical areas.
The value of these meetings has been immense, however given the move to larger Health Boards covering a number of multidisciplinary teams and maternity sites, Antenatal Screening Wales have decided to disband the LMMG’s and to encourage and support Health Boards in setting up their own meeting arrangements for multiprofessional communication.
ASW is considering how it should now continue to work effectively with service user organisations. The revised ASW structure is on the web site.
