Second trimester ultrasound prenasal thickness combined with nasal bone length: a new method of Down syndrome screening

Maymon, Ron; Levinsohn-Tavor, Orna; Cuckle, Howard; Tovbin, Y.; Dreazen, E.; Wiener, Yifat; Herman, Arie

doi:10.1002/pd.1207

Cited by 54 publications

(112 citation statements)

References 28 publications

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“…These results are compatible with those of previous studies [1,2,3,4,5,6,7] and suggest that measurement of the PFSR may provide an effective method of screening for trisomy-21 in the second-trimester of pregnancy.…”

Section: Discussionsupporting

confidence: 82%

“…Two previous studies that specifically examined prenasal thickness reported similar median values in normal fetuses of 2.4 mm at 16 weeks and about 4.5 mm at 24 weeks and in fetuses with trisomy-21 at 16-24 weeks the values were above the 95th percentile in 72% of 18 and 73% of 26 cases, respectively [1,2]. …”

Section: Discussionmentioning

confidence: 65%

“…In second-trimester fetuses with trisomy-21 there is increased prenasal skin thickness and midfacial hypoplasia manifested in shortening and/or dorsal displacement of the maxilla [1,2,3,4,5]. Sonek et al [6] proposed a new method of screening for trisomy-21 which exploits these two features of affected fetuses.…”

Section: Introductionmentioning

confidence: 99%

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Second-Trimester Screening for Trisomy-21 Using Prefrontal Space Ratio

et al. 2013

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Objective: To investigate the potential value of prefrontal space ratio (PFSR) in second-trimester screening for trisomy-21. Methods: A retrospective study utilizing stored midsagittal two-dimensional images of fetal profiles in 240 euploid and 45 trisomy-21 pregnancies at 16⁺⁰-23⁺⁶ weeks' gestation. The vertical distance between the leading edge of the skull and that of the skin (D1) and the distance between the skull and the mandibulo-maxillary line (D2) were measured and the D1:D2 ratio (PFSR) was calculated. In euploid pregnancies, regression analysis was used to determine the association between D1, D2 and PFSR with gestational age (GA). D1 and D2 were expressed as delta (Δ) values with gestational age. ΔD1, ΔD2 and PFSR in cases and controls were compared. Results: In trisomy-21, compared to controls, ΔD1 was increased (1.417 vs. 0.000 mm, p < 0.0001), ΔD2 was decreased (-0.842 vs. 0.000 mm, p = 0.003) and PFSR was increased (0.753 vs. 0.463, p < 0.0001). At a false-positive rate of 5%, the detection rates in screening by ΔD1, ΔD2 and PSFR were 80.0% (95% CI 65.4-90.4), 46.7% (95% CI 31.7-62.1) and 100.0% (95% CI 92.1-100.0), respectively. Conclusion: The PFSR is an effective marker in second-trimester screening for trisomy-21.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 65%

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Second-Trimester Screening for Trisomy-21 Using Prefrontal Space Ratio

et al. 2013

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“…Short nasal bone length (NBL), increased prenasal thickness (PT), and increased nuchal fold thickness (NF) are the most frequently investigated [1,2,3,4,5,6,7,8,9,10,11,12]. Recent studies have indicated that the use of ratios, such as the prenasal thickness to nasal bone length ratio (PT-NBL ratio) and the prefrontal space ratio (PFSR), are strong and easy-to-use second-trimester markers [13,14,15].…”

Section: Introductionmentioning

confidence: 99%

Trends in Serial Measurements of Ultrasound Markers in Second and Third Trimester Down Syndrome Fetuses

Vos

Jong-Pleij

Bakker³

et al. 2015

Fetal Diagn Ther

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Objectives: To evaluate trends of nasal bone length (NBL), prenasal thickness (PT), nuchal fold (NF), prenasal thickness to nasal bone length (PT-NBL) ratio, and prefrontal space ratio (PFSR), measured serially in second- and third-trimester Down syndrome (DS) fetuses. Methods: Prenatal databases were searched for cases of continuing DS pregnancies with serial measurements, taken at least two weeks apart. Trends were plotted on previously reported normal ranges. Results: Serial measurements were available in 25 Down syndrome fetuses. Median gestational age (GA) was 25 weeks; average number of visits per case was 2.44, with a median interval of 39 days between investigations. In DS fetuses, NBL and PT showed fairly stable trends with gestation. PFSR, but especially NF, had a more unpredictable trend. The PT-NBL ratio was the most stable marker, remaining unchanged in 95% of cases. NBL, PT, and NF showed more deviance from the normal range with advancing gestation, but MoM values remained stable. All but two fetuses had ultrasound markers or structural anomalies, especially heart defects. Conclusions: The PT-NBL ratio is the most constant DS marker throughout gestation, following a predictable trend.

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“…The latest screening strategy for first and second trimester was introduced by Nicolaides et al ( 51,53,60,65,69,70,[74][75][76][77][78][79][80][81][82][83] CRL, BPD, FHR and FL were measured from the beginning of the obstetric ultrasound era.…”

Section: The Explanation Of the Resultsmentioning

confidence: 99%

New aspects and the integration of the first and early second trimester screening to the feto-maternal medicine

Szili¹

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Second trimester ultrasound prenasal thickness combined with nasal bone length: a new method of Down syndrome screening

Cited by 54 publications

References 28 publications

Second-Trimester Screening for Trisomy-21 Using Prefrontal Space Ratio

Second-Trimester Screening for Trisomy-21 Using Prefrontal Space Ratio

Trends in Serial Measurements of Ultrasound Markers in Second and Third Trimester Down Syndrome Fetuses

New aspects and the integration of the first and early second trimester screening to the feto-maternal medicine

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