Can Robin Sequence Be Predicted From Prenatal Ultrasonography?

Nguyen, Josephine Q.N.; Calabrese, Carly E.; Heaphy, Kathryn J.; Estroff, Judy A.; Resnick, Cory M.

doi:10.1016/j.joms.2019.10.015

Cited by 15 publications

(18 citation statements)

References 17 publications

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“…Most research groups have focused on the IFA [1,9,10,13,27]. Our results are similar to those published previously.…”

Section: Discussionsupporting

confidence: 91%

“…Besides subjective assessment of the facial profile [7], several quantitative approaches have been used to identify retrognathia and RS and to distinguish both entities [1,2,8,9,10,11,12,13]. In a large prospective study of about 8,000 pregnancies, Bronshtein at al.…”

Section: Zusammenfassungmentioning

confidence: 99%

“…Therefore, micro-and retrognathia remain the key prenatal feature for the detection of both isolated retrognathia and RS. In addition to the subjective assessment of the fetal facial profile, some groups have tried to standardize diagnosis by assessing the inferior facial angle (IFA) [1,9,10], the maxilla-nasion-mandible angle (MNM) [12], and the fetal profile line (FPL; ▶ Fig. 1, ▶ Fig.…”

Section: Zusammenfassungmentioning

confidence: 99%

“…2) [11]. However, none have examined whether these markers can be used to distinguish between retrognathia and RS [1,9,11,12,15].…”

Section: Zusammenfassungmentioning

confidence: 99%

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Fetal Profile Markers for the Detection of Robin Sequence in Fetuses with Retrognathia

et al. 2021

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Objective To determine whether the prefrontal space ratio (PSFR), inferior facial (IFA) and maxilla-nasion-mandible angle (MNM), and the fetal profile line (FPL) are helpful in identifying fetuses with Robin sequence (RS) in cases with isolated retrognathia, and thus better predict the likelihood of immediate need for postnatal respiratory support. Methods This was a retrospective matched case-control study of fetuses/infants with isolated retrognathia with or without RS receiving pre- and postnatal treatment at the University Hospital of Tübingen, Germany between 2008 and 2020. The PFSR, IFA, MNM, and FPL were measured in affected and normal fetuses according to standardized protocols. Cases were stratified into isolated retrognathia and RS. Results 21 (n=7 isolated retrognathia, n=14 RS) affected fetuses and 252 normal fetuses were included. Their median gestational age at ultrasound examination was 23.6 and 24.1 weeks, respectively. In fetuses with isolated retrognathia and RS, the PSFR, IFA, and FPL were significantly different from the normal population. At a false-positive rate of 5%, the detection rate was 76.2% for the PFSR, 85.7% for the IFA, and 90.5% for both parameters combined. However, all parameters failed to distinguish between isolated retrognathia and RS. Conclusion PSFR and IFA are simple markers for identifying retrognathia prenatally. However, they are not helpful for the detection of RS in fetuses with isolated retrognathia. Therefore, delivery should take place in a center experienced with RS and potentially life-threatening airway obstruction immediately after birth.

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“…Most research groups have focused on the IFA [1,9,10,13,27]. Our results are similar to those published previously.…”

Section: Discussionsupporting

confidence: 91%

Section: Zusammenfassungmentioning

confidence: 99%

Section: Zusammenfassungmentioning

confidence: 99%

“…2) [11]. However, none have examined whether these markers can be used to distinguish between retrognathia and RS [1,9,11,12,15].…”

Section: Zusammenfassungmentioning

confidence: 99%

See 2 more Smart Citations

Fetal Profile Markers for the Detection of Robin Sequence in Fetuses with Retrognathia

et al. 2021

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“…As a parent I am greatly encouraged by the promising research which is being carried out to improve the prenatal diagnosis of RS. 1 An early diagnosis of any disease benefits healthcare providers, patients and families in multiple ways. Also, many RS babies suffer from one or more associated conditions; a red flag for RS would alert clinicians of the need to vigilantly search for these associated conditions.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

A parent's view on the care of their baby with Robin sequence

Pakter¹

2021

Seminars in Fetal and Neonatal Medicine

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Identification of micrognathia by prenatal ultrasound may improve timely diagnosis and management of infants with Robin sequence

2023

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Objective: Robin sequence (RS) is a craniofacial anomaly characterized by small jaw (micrognathia) with associated tongue base airway obstruction. With advances in fetal imaging, micrognathia may be detected prenatally. This study aims to determine if prenatal recognition of micrognathia offers any advantage over being unaware of the condition until after delivery and to assess if prenatal consultation for micrognathia adds benefits beyond merely noting the presence of the condition. Method:Retrospective chart review examining cases from 01/01/2010 to 12/31/ 2020 at an urban tertiary medical center.Results: Forty seven infants with RS were included. 40.4% (n = 19) had micrognathia/retrognathia noted on prenatal ultrasound. 47.4% (n = 9) of those 19 pregnancies saw a maternal fetal medicine (MFM) program with craniofacial consultation. Compared to 28 infants not diagnosed with micrognathia until after birth, the 19 infants identified prenatally required fewer transfers from birth hospital (p = 0.02). Additionally, those referred to MFM with craniofacial consultation had shorter lengths of stay when airway intervention was required (p = 0.05). Conclusion:Prenatal recognition of micrognathia may lead to early detection and management of RS. When RS is suspected, prenatal consultation with MFM and craniofacial team may further optimize care of the infant following delivery. Key points� Robin sequence (RS) in newborns may require interventions and prolonged hospital stay to address airway concerns and failure to thrive � To our knowledge, no study has assessed differences in outcomes between infants diagnosed with RS prenatally and those that were not � This study suggests a possible relationship between early identification of RS and fewer hospital transfers as well as a shorter length of hospital stay after birth.

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Can Robin Sequence Be Predicted From Prenatal Ultrasonography?

Cited by 15 publications

References 17 publications

Fetal Profile Markers for the Detection of Robin Sequence in Fetuses with Retrognathia

Fetal Profile Markers for the Detection of Robin Sequence in Fetuses with Retrognathia

A parent's view on the care of their baby with Robin sequence

Identification of micrognathia by prenatal ultrasound may improve timely diagnosis and management of infants with Robin sequence

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