Ultrasonographic evaluation of fetal nasal bone in a low-risk population at 11–13 + 6 gestational weeks

Ramos-Corpas, D.; Santiago, J.C.; Montoya, F.

doi:10.1002/pd.1345

Cited by 15 publications

(13 citation statements)

References 30 publications

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“…However, this figure is consistent with recent publications reporting a lower prevalence in unselected populations [9,16] . Similar findings were reported in the FASTER study, where none of the trisomy 21 fetuses showed the absence of nasal bone; however, this study is criticized based on the nasal bone evaluation technique used [13] .…”

Section: Discussionsupporting

confidence: 82%

“…The nasal bone was found to be absent in 33% (3/9) of fetuses with trisomy 21 in our study, which is lower than in the initial reports which usually reported around 70% [1,5,6,9,14,18,19] . However, this figure is consistent with recent publications reporting a lower prevalence in unselected populations [9,16] .…”

Section: Discussioncontrasting

confidence: 55%

“…Most screening studies reported this figure around 0.5-1% [6][7][8][9] . It is suggested that there are significant differences in the rates of visualization of the fetal nasal bones in the first trimester in mothers of different ethnic origin.…”

Section: Discussionmentioning

confidence: 99%

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Fetal Nasal Bone Assessment in First Trimester Down Syndrome Screening

Has¹,

Kalelioğlu²,

Yüksel³

et al. 2008

Fetal Diagn Ther

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Objective: To evaluate the contribution of nasal bone assessment in the first trimester Down syndrome screening. Methods: The fetuses which underwent first trimester screening with nuchal translucency (NT) measurement were evaluated for the absence or presence of nasal bone according to the instructions described by the Fetal Medicine Foundation, London. Results: Among the 1,807 fetuses included in the study, 9 had trisomy 21. The detection rate of Down syndrome with NT measurement was 77.8% (7/9) with a false-positive rate of 4.5%. Incorporation of biochemical tests (PAPP-A, and free β-hCG measurement) into the screening increased the detection rate to 88.9% (8/9) and decreased the false-positive rate to 3.6%. The prevalence of absent nasal bone was 7/1,798 (0.39%) in chromosomally normal fetuses, and 3/9 (33.3%) in Down syndrome fetuses. Sensitivity, specificity, positive predictive and negative predictive values of absence of nasal bone for trisomy 21 are 33.3% (CI: 0.12–0.64), 99.6% (CI: 0.99–0.99), 30% (95% CI: 0.11–0.53) and 99.7% (95% CI: 0.99–0.99), respectively. The positive likelihood ratio of absent nasal bone was 85.6 (95% CI: 26.2–279.5), and the negative likelihood was 0.67 (95% CI: 0.42–1.06). When nasal bone assessment was incorporated into the NT risk assessment or combined test, the detection rate of trisomy 21 was not changed, however, the false-positive rate decreased to 3.4 and 3%, respectively. Conclusion: The absence of fetal nasal bone has a high positive likelihood ratio for Down syndrome in the first trimester screening, and the presence of nasal bone may potentially lower the need for invasive testing.

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Section: Discussionsupporting

confidence: 82%

Section: Discussioncontrasting

confidence: 55%

See 1 more Smart Citation

Fetal Nasal Bone Assessment in First Trimester Down Syndrome Screening

Has¹,

Kalelioğlu²,

Yüksel³

et al. 2008

Fetal Diagn Ther

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“…Initially, sonographic assessment of the NB was thought to be a useful marker for screening for trisomy 21 in the first trimester. Inconsistent findings in subsequent studies, however, have diminished its value [40]. Sepulveda et al [41] used first-trimester nuchal translucency and NB assessment over a three-year period in 1,287 consecutive singleton cases in a recent study.…”

Section: Nasal Bone (Nb)mentioning

confidence: 98%

First trimester ultrasound: current approaches and practical pitfalls

Öztekin¹

2009

J Med Ultrasonics

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Revolutionary technological improvements and high-frequency transvaginal scanning have enabled the resolution of ultrasound imaging in the first trimester to increase such that detailed early fetal development can now be well visualized. This investment in imaging technology has enabled not only normal embryonic development but also chromosomal abnormalities and structural anomalies to be more easily and accurately diagnosed before the second trimester. This article is intended to help radiologists in the interpretation and clinical application of normal and abnormal first trimester ultrasound findings in early pregnancy. We review the current literature and applications and interpretations of first trimester ultrasound.

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“…It has been reported that about 65% of Down syndrome fetuses have absent or short NB in fetal NB screening at the first and second trimesters [4]. Only 1~2% of normal karyotype fetuses have been observed [5][6][7]. Down syndrome and absent or hypoplastic fetal NB show similar evidence of high sensitivity, high specificity, and low false-positive rate for Down syndrome screening by fetal NB examination [8][9][10][11].…”

Section: Introductionmentioning

confidence: 78%

Investigation of Bone Ratios for Prenatal Fetal Assessment in Taiwanese Population

Yang¹,

Yi²

2012

ENG

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The purpose of this study is to calculate the ratios of fetal limb bone to nasal bone length (NBL) obtained by transabdominal ultrasound between 19 and 28 weeks of gestation. Cross-sectional data were obtained from 1408 women with singleton pregnancies who underwent an advanced prenatal ultrasound examination from August 2006 to September 2008. The single measurement plane of fetal limb bones was on the longest section of each structure with appropriate image magnification. To assess repeatability of the intraobserver, two repeated measurements were obtained in 44 fetuses. The ratio of fetuses with biparietal diameter (BPD)/NBL was compared with those of fetal limb bones/NBL. The mean ratio was found between fetal NBL measurements and BPD (7.240), humerus length (HL) (4.807), radius length (RL) (4.157), ulna length (UL) (4.502), femur length (FL) (5.131), tibia length (TL) (4.528), and fibula length (FiL) (4.507). The reference ranges of fetal long bone length/NBL ratios for the second trimester was established by transabdominal sonography. There were no significant increases in these ratios with gestational age, especially the HL/NBL ratio.

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Ultrasonographic evaluation of fetal nasal bone in a low-risk population at 11–13 + 6 gestational weeks

Abstract: In a low-risk population, the evaluation of the presence/absence of nasal bone in DS screening during the first trimester has a low sensitivity. First-trimester assessment of the nasal bone in population screening may play a lesser role than in the re-evaluation of high-risk pregnancies.

Cited by 15 publications

References 30 publications

Fetal Nasal Bone Assessment in First Trimester Down Syndrome Screening

Fetal Nasal Bone Assessment in First Trimester Down Syndrome Screening

First trimester ultrasound: current approaches and practical pitfalls

Investigation of Bone Ratios for Prenatal Fetal Assessment in Taiwanese Population

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