Additional Performance of Nasal Bone in First Trimester Screening

Kozlowski, P.; Knippel, Alexander Johannes; Froehlich, S.; Stressig, R.

doi:10.1055/s-2005-858880

Cited by 8 publications

(5 citation statements)

References 7 publications

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“…The findings of this prospective screening study demonstrate that at 11–13 weeks there is absence of the nasal bone in 1–2% of euploid fetuses, in 60% of fetuses with trisomy 21 and in about half of fetuses with trisomies 18 and 13. These findings are consistent with the results of previous screening studies11, 18–22.…”

Section: Discussionsupporting

confidence: 93%

Fetal nasal bone in screening for trisomies 21, 18 and 13 and Turner syndrome at 11–13 weeks of gestation

Kagan

Cicero

Staboulidou

et al. 2009

Ultrasound in Obstet & Gyne

144

116

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Section: Discussionsupporting

confidence: 93%

Fetal nasal bone in screening for trisomies 21, 18 and 13 and Turner syndrome at 11–13 weeks of gestation

Kagan

Cicero

Staboulidou

et al. 2009

Ultrasound in Obstet & Gyne

144

116

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“…In fact, sensitivity was higher when that marker was excluded from the calculations. According to these authors, DR with and without NB evaluation was 77.8% and 94.4%, respectively for cut-off level of 1:300 [12]. Our data showed higher efficacy (DR of 84.5 and 93.0% respectively), with low rates of false-positive results (FPR of 10.7 and 2.0% respectively).…”

Section: Discussionmentioning

confidence: 61%

Nasal bone in screening for T21 at 11–13 + 6 weeks of gestation — a multicenter study

et al. 2016

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Objectives: Trisomy 21 is one of the most common chromosomal defects diagnosed prenatally. Screening for Down syndrome is based on maternal age, measurement of crown-rump length, nuchal translucency and fetal heart rate, together with free β-hCG and PAPP-A at 11 to 13 + 6 weeks. Introduction of additional ultrasound marker of trisomy 21 (evaluation of the nasal bone) may result in increased DR and decreased invasive diagnostic testing rates (FPR). Material and methods:Ultrasound scan with NB evaluation was performed in 5814 fetuses during routine screening for chromosomal defects at 11 to 13 + 6 weeks of gestation. DR and FPR coefficients were calculated for 4 levels of risk as cut-off points for screening model 1, based on MA, NT, and first trimester biochemistry, as well as for screening model 2, based on MA, NT, first trimester biochemistry and NB.Results: There were 5708 normal cases, 71 cases of trisomy 21 and 35 cases of other chromosomal defects. NB was absent in 46 (64.8%) cases and present in 25 (35.3%) cases of trisomy 21, comparing to present NB in 5463 (95.7%) and absent in 245 (4.3%) of normal cases. Conclusions:First-semester screening with additional NB assessment significantly increases the detection rate for trisomy 21 and decreases the rate of false-positive results. Adding NB evaluation at the risk level of 1:50 causes only a small increase in detection rate. Invasive procedures should be performed in that group regardless NB assessment.

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“…However, these results confirm the assessment that accurate examination of the nasal bone requires highly skilled sonographers and it is difficult to incorporate in the routine first trimester scan. Individual risk-oriented two-stage screening in specialist centers as proposed first by Nicolaides et al [16] and then by Kozlowski et al [10] should be performed instead. The prerequisite for the feasibility and implementation of the nasal bone length measurement is satisfactory qualification of an experienced sonographer.…”

mentioning

confidence: 99%

Interobserver Variability of the Measurement of Fetal Nasal Bone Length between 11 + 0 and 13 + 6 Gestation Weeks among Experienced and Inexperienced Sonographers

Staboulidou

Wüstemann²,

Vaske³

et al. 2008

Ultraschall in Med

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The uncertainty and the difficulties of an inexperienced examiner with the presenting of the nasal bone, as shown by published data sets as well as by the variability of the measurement results of this study, with all the consequences in the risk calculation and counseling show that this tool should only be implemented by experienced and quality-controlled sonographers with a minimum amount of examinations. Because of its major impact in risk calculation and the importance of the nasal bone as a sonographic marker, documentation of the sonographer's skills is mandatory for the use of the nasal bones as an additional sonographic marker in first trimester screening.

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Additional Performance of Nasal Bone in First Trimester Screening

Cited by 8 publications

References 7 publications

Fetal nasal bone in screening for trisomies 21, 18 and 13 and Turner syndrome at 11–13 weeks of gestation

Fetal nasal bone in screening for trisomies 21, 18 and 13 and Turner syndrome at 11–13 weeks of gestation

Nasal bone in screening for T21 at 11–13 + 6 weeks of gestation — a multicenter study

Interobserver Variability of the Measurement of Fetal Nasal Bone Length between 11 + 0 and 13 + 6 Gestation Weeks among Experienced and Inexperienced Sonographers

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