Nuchal Translucency Quality Assurance (NTQA)

Overview

The Nuchal Translucency Quality Assurance (NTQA) program is a province-wide initiative in Ontario, coordinated through BORN Ontario and Prenatal Screening Ontario (PSO). It monitors the quality and accuracy of nuchal translucency (NT) ultrasounds performed during early pregnancy, providing feedback and support to sonographers and screening centres.

By promoting consistent practices and high standards across the province, the program helps ensure that prenatal screening results are as reliable as possible, supporting informed decision-making for families and health-care providers.

Why This Matters

The nuchal translucency (NT) ultrasound provides important information about a baby’s health early in pregnancy. When combined with blood test results and maternal age, it helps estimate the chance that the baby may have a chromosomal condition, such as Down syndrome (trisomy 21) or trisomy 18.
Because these measurements are very small, they must be done carefully and consistently. That’s why quality assurance is so important.

BORN's Role

BORN Ontario houses Prenatal Screening Ontario (PSO), which leads the Nuchal Translucency Quality Assurance (NTQA) program for the province. Through PSO, BORN provides the infrastructure, data systems, and expertise needed to support this work.

PSO's work role includes:

Collecting and analyzing data from NT ultrasounds across Ontario to monitor quality and identify trends.
Providing feedback and education to sonographers and screening centres to help maintain high standards.
Facilitating consistency by supporting standardized protocols and practices across the province.
Supporting system improvements by sharing information with providers, clinics, and policy-makers to guide best practices in prenatal screening.

Impact and Benefits

A smiling pregnant person leaning against a wall holding her belly.

For Patients

Timely, accurate prenatal screening results – provides early estimates of conditions such as Down syndrome or trisomy 18
Early identification of potential conditions – supports timely referrals, coordinated care, and better outcomes

For Providers

Access to personalized NT performance data – via the BORN Information System (BIS)
Insight into scanning habits – helps identify strengths and areas for improvement
Opportunities to improve scanning performance – feedback supports professional development and skill maintenance

For Healthcare

Consistent, province-wide monitoring – helps prenatal screening programs maintain high standards
Reliable data for planning – supports system-level improvements and policy decisions
More equitable care across Ontario – promotes standardization and quality in all regions

Eligibility and Access

The 11-14 week (nuchal translucency) ultrasound can be done as part of enhanced First Trimester Screening or on its own.

In Ontario, this test can be arranged by:

doctors (such as family doctors, obstetricians)
nurse practitioners
midwives

More Details about this Ultrasound

Health-care practitioners provide patients with a requisition form and may schedule the ultrasound on their behalf.

In some cases, patients are asked to book the ultrasound themselves by calling the phone number listed on the requisition.

Feature Story

Imagine a job where you’re required to make precise measurements (to the tenth of a millimeter), and if they’re not accurate, a pregnant person may be misinformed about their baby’s chance of having Down syndrome. This is the reality for sonographers performing obstetrical scans – their work is meticulous, and the responsibility is immense. Katie Virgin, a sonographer who participated in PSO’s Nuchal Translucency Quality Assurance Program, shares her experience and perspective on this critical work.

Read Katie's Story

Publications

Burnett-Roy, S., & Kuepfer, T. (2023). How is BORN data impacting the quality of nuchal translucency measurements? Canadian Journal of Medical Sonography, 14(1), 17-19. https://doi.org/10.3138/cjms.v14i1.62

Did You Know...

Ontario is the only province in Canada with a formal, province-wide Nuchal Translucency Quality Assurance (NTQA) program.

While sonographers across the country require specialized NT certification, Ontario’s program—run through BORN and Prenatal Screening Ontario—monitors results and provides feedback to support consistency and help facilitate high-quality screening across the province.

Stay Informed

For Sonographers

Check out the Prenatal Screening Ontario website for information about registering for the NTQA program, accessing the BORN Information System, and current news/updates.
Visit the Fetal Medicine Foundation (FMF UK) website for more information about the fetal NT, the relationship between the NT measurement and prenatal screening, and the diagnostic requirements of NT ultrasound.
Review the FMF UK 11-13 weeks scan course, including how to obtain high-quality NT images.
View a video by London Pregnancy Clinic describing the correct technique of an NT scan

For Families

Visit the Prenatal Screening website to learn more about what the ultrasound involves, who is eligible, how and where to get it, what the results mean and next steps