Normal Ranges for Fetal Femur and Humerus Diaphysis Length During the Second Trimester in an Iranian Population

Abstract

onographic markers are widely used for aneuploidy screening. Shortening of the fetal long bones such as the humerus and femur is a sonographic soft marker for screening of Down syndrome in the second trimester. Ethnic differences in fetal biometric measurements have been documented. [1][2][3] Beigi and ZarrinKoub 3 reported that Iranian fetuses had a shorter femur length in comparison with western studies. Kovac et al 1 concluded that Asian groups had a less-than-expected femur length.Undoubtedly, ethnic differences in fetal femur and humerus diaphysis length would have a considerable impact on Down syndrome screening; in one study, positive sonographic results were reported more frequently in nonwhite ethnicities because of shorter long bones. 2 In our previous study, we obtained normal ranges for the fetal nasal bone during the second trimester of pregnancy. 4 The aim of this study was to provide normal ranges for femur and humerus diaphysis length during the second trimester in an Iranian population. -Reza Tahmasebpour, MD, Reihaneh Pirjani, MD, Abbas Rahimi-Foroushani, PhD, Saeed Reza Ghaffari, MD, Fatemeh Rahimi-Sharbaf, MD, Farzaneh Fattahi Masrour, MD Received November 18, 2011, from the Iranian Fetal Medicine Foundation, Tehran, Iran (A.-R.T., S.R.G., F.F.M.) Ahmad ORIGINAL RESEARCHObjectives-Shortening of the fetal long bones is a sonographic soft marker for screening of Down syndrome in the second trimester that can be influenced by ethnicity. The purpose of this study was to provide normal reference ranges for femur and humerus diaphysis length during the second trimester of pregnancy in an Iranian population.Methods-This cross-sectional study was performed on 3011 singleton fetuses at 15 to 28 weeks' menstrual age. The relationship between menstrual age and both femur and humerus diaphysis length was determined, and percentile values for each menstrual week were provided.Results-The median femur diaphysis length ranged from 18.05 mm at 15 menstrual weeks to 52.20 mm at 28 menstrual weeks, and the mean humerus diaphysis length ranged from 17.65 mm at 15 menstrual weeks to 48.10 mm at 28 menstrual weeks. There was a linear relationship between menstrual age and both femur diaphysis length (R 2 = 0.957) and humerus diaphysis length (R 2 = 0.941).Conclusions-We have provided normal reference ranges for femur and humerus diaphysis length during the second trimester of pregnancy in an Iranian population.

Cross‐sectional study of fetal long‐bone length in an Iranian population at 17–25 weeks of gestation

“…The present study was conducted among a general population from Iran to obtain a suitable sample for the generation of new reference values; the obtained femur and humerus lengths demonstrated similar values to those from a previous report in an Iranian population, suggesting that the acquired equations could be applicable to all fetuses in Iran.…”

“…Comparison of experimental femur (A) and humerus (B) length between the present study (green lines) and data from Tahmasebpour et al. (black lines) . Our findings (green) for (A) Femur and (B) Humerus length, with the previously reported study on another Iranian population (black) .…”

“…(black lines) . Our findings (green) for (A) Femur and (B) Humerus length, with the previously reported study on another Iranian population (black) . Dashed lines represent the fifth and 90th centile values and the solid lines represent the 50th centile.…”

“…The 50th centile femur and humerus lengths at different durations of gestation were compared with equivalent values from a previous study conducted among an Iranian population, with similar trends in the lengths observed (Data S6). Similarly, the 50th centile femur length values were compared visually with those from studies conducted in Asian (China, Korea, Singapore, Bangladesh, and Pakistan), European (UK, Italy, Norway, and Poland), and other populations (North America, Nigeria, and Brazil) (Fig.…”

Comparação do comprimento do úmero em fetos portadores de Síndrome de Down com o comprimento do úmero em fetos normais

“…Gray et al (2009) 42 , em um estudo de caso-controle, analisou o comprimento do úmero numa população normal e comparou com o comprimento do úmero em fetos com Síndrome de Down para determinar o parâmetro discriminatório mais eficiente para a acurácia do diagnóstico. DBP), comprimento do úmero maior que 1,3;1,4;1,5;1,6;1,7;1,75;1,8;1,85 desviospadrão acima da média para a idade gestacional, comprimento do úmero úmero em relação ao comprimento encontrado em fetos normais e com T2145,46,58,59 . Nesse sentido, o estudo de Ogasawara et al46 teve o objetivo de avaliar se a biometria fetal ao ultrassom era afetada pelas diferentes etnias, comparadas com os controles da raça branca na detecção da T21, e concluiu que o ultrassom morfológico do segundo trimestre era positivo para presença de ossos longos curtos mais frequentemente em todas as etnias não brancas.…”