Nuchal translucency-based Down syndrome screening: barriers to implementation

Nuchal translucency sonography represents an important step forward in screening for Down syndrome. It is likely that a range of screening programs that rely on nuchal translucency sonography will become popular for general population screening. However, a number of practical implementation issues remain to be resolved before widespread utilization of this technique can be endorsed. This paper addresses some of these issues, including sonographer training, standardized nuchal translucency sonography protocol, ongoing nuchal translucency quality assurance programs, how to interpret Down syndrome risk, availability of first trimester diagnosis, and how to combine screening tests across different gestational ages.