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We plan to launch our free introductory online course, Increased NT at 10 Weeks: Diagnosis, Management and Prognosis, in autumn 2026. Register your interest to receive updates about the exact course launch date, the programme, and future educational activities.

KNOVA NIPT may not currently be available in every country, and access can vary depending on local regulations, sample collection arrangements, shipping requirements and customs rules. A practical first step is to contact a genetics provider such as Jeen (jeen.health) and ask whether KNOVA can be arranged in your country. Jeen states that KNOVA is available across the UK and in some EU regions, and that testing can be organised either through a self-arranged blood draw or through participating clinics. Jeen also states that KNOVA can be performed from 10 weeks, with a typical laboratory turnaround time of 7 to 10 working days from receipt of the sample.

For patients with increased NT, it is often preferable to work with a provider specialising in both fetal ultrasound and genomics, so that the pathway can be coordinated properly. London Pregnancy Clinic (LPC) has experience with KNOVA testing and also sees international patients. LPC states that patients do not need to be registered with the NHS to have screening there, and that results can be communicated to an overseas healthcare provider. LPC also emphasises that NIPT should be combined with expert ultrasound, because NIPT cannot detect structural abnormalities such as heart or brain defects. Their team notes that some severe fetal anomalies may be detectable as early as 10 weeks, which is why a specialist scan is an important first step for pregnancies with increased NT.

This is important because, in a pregnancy with increased NT, a specialist scan may identify structural findings that change the counselling, clarify the level of risk, or influence whether further diagnostic testing should be considered. If the scan is reassuring, KNOVA may then serve as an additional screening option for severe genetic conditions. If the patient is travelling from abroad, working with an experienced centre may also make the process smoother by helping to coordinate the scan, blood sampling, reporting and communication with the patient’s local doctor. Even so, cross-border testing can still be affected by practical issues such as local phlebotomy arrangements, transport logistics and country-specific import rules, so it is always sensible to confirm feasibility in advance.

Our formal theoretical programme on the 10 Week Scan and NIPT approach is currently in development, with the aim of providing a structured introduction to the principles, clinical pathway, case selection, counselling, interpretation of findings, and follow-up management.

In addition, observational experience at London Pregnancy Clinic (LPC) may also be possible and can be discussed on an individual basis. This can be particularly valuable for clinicians who want to see how the pathway works in real clinical practice, including early ultrasound assessment, decision-making, and integration with genomic testing.

If you are interested, the LPC management would be happy to discuss your background, level of experience, and what type of training or observation would be most useful for you.

SMART NT Affiliated Clinic is a clinic connected to the SMART NT professional network, dedicated to advancing care for pregnancies with increased nuchal translucency. Affiliation reflects a strong interest in the SMART NT approach, including early expert ultrasound, advanced prenatal genomic screening, and structured follow-up pathways.

It also offers valuable opportunities for training, education, collaboration, and professional support, including access to a wider network of clinicians who can help with challenging and complex cases. In this way, a SMART NT Affiliated Clinic becomes part of an international effort to raise standards, share expertise, and improve care for families facing increased NT.

Contact us today to find out more and register your interest.

No, absolutely not. We do not have any financial relationship with Fulgent other than using their genomic services in clinical practice. We also work with multiple laboratories in different countries and aim to remain objective in our recommendations.

The clinical reason why KNOVA NIPT has been selected as the main NIPT we currently advise in cases of increased NT is straightforward. At present, KNOVA offers the most balanced panel for this specific indication, including assessment for a wide range of monogenic conditions known to be associated with increased NT. It also has a very low no-call rate, reported to be less than 1%.

We strongly believe that competition between genetic companies is important and ultimately benefits patients and clinicians. It is entirely possible that other laboratories will develop better NIPT options in the future. We continuously review developments in prenatal genomics and reassess the available evidence. If another test proves to be better suited for this clinical scenario, we would be fully prepared to update our SMART NT pathway accordingly.

We currently have experience only with GE Voluson systems, including both the Expert and Signature series. For that reason, we cannot give specific recommendations regarding other ultrasound vendors, as we do not have direct hands-on experience with them. That said, we recognise that several other manufacturers are also capable of producing high-quality imaging.

For the transabdominal 10 Week Scan, we mainly use the microconvex C2-9 probe and, in some cases, the 9L linear probe, provided that the machine settings are well optimised.

For transvaginal scanning, we use only 3D probes. Our preferred option is the RIC 6-12-D, which offers excellent resolution, although its penetration can be limited and it may be less suitable in technically difficult examinations. The RIC 5-9-D is also a very good and reliable option. The newer RIC 10-D appears to offer a good balance between resolution and penetration.

To assess a fetus measuring only 3–4 cm, you need an ultrasound system with very high spatial resolution. A premium system is ideal, and high-end consoles are generally preferable, although some good mid-range platforms may also be suitable if image quality and probe performance are strong enough. A system with dedicated OB/GYN applications is strongly preferable.

Probes are critically important. For the main transabdominal examination, the preferred probe is usually a high-frequency microconvex transducer or, in selected situations, a high-frequency linear probe, ideally in the 7.5–10 MHz range. These can provide the level of detail needed for the 10 Week Scan.

For the transvaginal examination, we believe that 3D/4D capability is essential for clinical work at 10 weeks, so the transvaginal probe should be a 3D/4D probe. Frequencies in the 10–12 MHz range are preferable, as they provide better resolution for early fetal anatomy assessment.

Finally, machine tuning and preset optimisation are extremely important. Even good equipment may underperform if the settings are not properly adjusted, while a well-optimised system can make a major difference to image quality and diagnostic confidence during the 10 Week Scan.

The NT criteria used at 10 weeks differ from the FMF and NHS criteria because the standard FMF/NHS rules were designed for a later stage of the first trimester, when the fetal CRL is 45–84 mm. At 10 weeks, the fetus is smaller and anatomically less mature, so the same measurement framework cannot be applied in exactly the same way.

The SMART NT approach therefore uses dedicated 10-week criteria for fetuses with CRL below 45 mm, before reverting to standard FMF criteria once the fetus reaches the official range. These criteria are based on published evidence showing that increased NT before 11 weeks is a clinically important finding associated with a significant risk of adverse outcome. At the same time, they should be understood as part of the SMART NT clinical approach, rather than as official FMF or NHS guidance.

LPC is a principal private provider of advanced first-trimester ultrasound in London and the UK. It has developed a distinctive 10 Week Scan and NIPT approach, designed to bring together very early detailed ultrasound assessment with appropriately selected prenatal genomic screening. LPC has extensive experience with different types of NIPT, including their strengths, limitations, and role within the wider clinical pathway. Its work also includes the assessment and management of pregnancies with early ultrasound abnormalities, including increased NT, and the integration of imaging with genetic counselling and follow-up testing.

For your practice, LPC’s experience may be relevant in several ways: it can help inform earlier risk assessment, improve understanding of how to combine ultrasound and NIPT effectively, and support more structured counselling and referral pathways for complex first-trimester cases.

Never. In fact, we ask patients to attend with an empty bladder.

A full bladder can push the uterus away from the suprapubic area, which is the part of the abdomen with the thinnest subcutaneous tissue layer. During the transabdominal scan, this can reduce image resolution.

An overfilled bladder may also lead to contraction of the isthmic part of the uterus after the patient empties it. This contraction can significantly interfere with transvaginal imaging.

A full bladder is also simply uncomfortable for patients and can become an unnecessary distraction during the examination, especially when careful attention and good cooperation are important.

In summary, we ask women to empty their bladder before the 10 Week Scan.