Fetal nasal bone length: Reference range and clinical application in ultrasound screening for trisomy 21

V. Bunduki, Rodrigo Ruano, J. Miguelez, C. T. Yoshizaki, S. Kahhale, M. Zugaib

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

Objectives: Fetuses with trisomy 21 typically present with subtle facial abnormalities, including a hypoplastic nasal bone. The aim of this study was to provide a reference range for the length of the fetal nasal bone and to test its value in second-trimester ultrasound screening for trisomy 21. Design: A reference range of fetal nasal booze length was established from cross-sectional data on 1923 consecutive singleton pregnancies scanned at 16-24 weeks' gestation in women older than 35 years. Screening for trisomy 21 was prospectively studied using the measurement o f fetal nasal bone lengths smaller than the 5th percentile as a cut-off value. Results: Follow-up was possible in 1631 cases (84.8%). Trisomy 21 was found in 22 cases (1.35%). Nasal bone length measurement increased as a function of gestational age (P < 0.05) showing a linear relationship. Screening for trisomy 21 using the 5th percentile as a cut-off value resulted in a sensitivity of 59.1% for a 5.1% false-positive rate. The likelihood ratio was 11.6. Conclusion: Screening for trisomy 21 using fetal nasal bone length measurements showed a sensitivity comparable to that of maternal biochemistry for a given false-positive rate of 5%. Association of nasal bone lengths with other sonographic markers, taking into account the background risk for maternal and gestational age, may further improve sensitivity and reduce false positives, allowing avoidance of unnecessary invasive diagnostic procedures.

Original languageEnglish (US)
Pages (from-to)156-160
Number of pages5
JournalUltrasound in Obstetrics and Gynecology
Volume21
Issue number2
DOIs
StatePublished - Feb 1 2003
Externally publishedYes

Fingerprint

Nasal Bone
Down Syndrome
bones
Reference Values
screening
Gestational Age
sensitivity
cut-off
likelihood ratio
Pregnancy
biochemistry
avoidance
pregnancy
fetuses
Maternal Age
abnormalities
Second Pregnancy Trimester
Nose
Biochemistry
markers

Keywords

  • Chromosomal abnormalities
  • Fetus
  • Nasal bone
  • Trisomy 21
  • Ultrasound

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Radiology Nuclear Medicine and imaging
  • Reproductive Medicine
  • Acoustics and Ultrasonics
  • Radiological and Ultrasound Technology

Cite this

Fetal nasal bone length : Reference range and clinical application in ultrasound screening for trisomy 21. / Bunduki, V.; Ruano, Rodrigo; Miguelez, J.; Yoshizaki, C. T.; Kahhale, S.; Zugaib, M.

In: Ultrasound in Obstetrics and Gynecology, Vol. 21, No. 2, 01.02.2003, p. 156-160.

Research output: Contribution to journalArticle

Bunduki, V. ; Ruano, Rodrigo ; Miguelez, J. ; Yoshizaki, C. T. ; Kahhale, S. ; Zugaib, M. / Fetal nasal bone length : Reference range and clinical application in ultrasound screening for trisomy 21. In: Ultrasound in Obstetrics and Gynecology. 2003 ; Vol. 21, No. 2. pp. 156-160.
@article{5d71600863454e26b5a9de1dbd421c1c,
title = "Fetal nasal bone length: Reference range and clinical application in ultrasound screening for trisomy 21",
abstract = "Objectives: Fetuses with trisomy 21 typically present with subtle facial abnormalities, including a hypoplastic nasal bone. The aim of this study was to provide a reference range for the length of the fetal nasal bone and to test its value in second-trimester ultrasound screening for trisomy 21. Design: A reference range of fetal nasal booze length was established from cross-sectional data on 1923 consecutive singleton pregnancies scanned at 16-24 weeks' gestation in women older than 35 years. Screening for trisomy 21 was prospectively studied using the measurement o f fetal nasal bone lengths smaller than the 5th percentile as a cut-off value. Results: Follow-up was possible in 1631 cases (84.8{\%}). Trisomy 21 was found in 22 cases (1.35{\%}). Nasal bone length measurement increased as a function of gestational age (P < 0.05) showing a linear relationship. Screening for trisomy 21 using the 5th percentile as a cut-off value resulted in a sensitivity of 59.1{\%} for a 5.1{\%} false-positive rate. The likelihood ratio was 11.6. Conclusion: Screening for trisomy 21 using fetal nasal bone length measurements showed a sensitivity comparable to that of maternal biochemistry for a given false-positive rate of 5{\%}. Association of nasal bone lengths with other sonographic markers, taking into account the background risk for maternal and gestational age, may further improve sensitivity and reduce false positives, allowing avoidance of unnecessary invasive diagnostic procedures.",
keywords = "Chromosomal abnormalities, Fetus, Nasal bone, Trisomy 21, Ultrasound",
author = "V. Bunduki and Rodrigo Ruano and J. Miguelez and Yoshizaki, {C. T.} and S. Kahhale and M. Zugaib",
year = "2003",
month = "2",
day = "1",
doi = "10.1002/uog.31",
language = "English (US)",
volume = "21",
pages = "156--160",
journal = "Ultrasound in Obstetrics and Gynecology",
issn = "0960-7692",
publisher = "John Wiley and Sons Ltd",
number = "2",

}

TY - JOUR

T1 - Fetal nasal bone length

T2 - Reference range and clinical application in ultrasound screening for trisomy 21

AU - Bunduki, V.

AU - Ruano, Rodrigo

AU - Miguelez, J.

AU - Yoshizaki, C. T.

AU - Kahhale, S.

AU - Zugaib, M.

PY - 2003/2/1

Y1 - 2003/2/1

N2 - Objectives: Fetuses with trisomy 21 typically present with subtle facial abnormalities, including a hypoplastic nasal bone. The aim of this study was to provide a reference range for the length of the fetal nasal bone and to test its value in second-trimester ultrasound screening for trisomy 21. Design: A reference range of fetal nasal booze length was established from cross-sectional data on 1923 consecutive singleton pregnancies scanned at 16-24 weeks' gestation in women older than 35 years. Screening for trisomy 21 was prospectively studied using the measurement o f fetal nasal bone lengths smaller than the 5th percentile as a cut-off value. Results: Follow-up was possible in 1631 cases (84.8%). Trisomy 21 was found in 22 cases (1.35%). Nasal bone length measurement increased as a function of gestational age (P < 0.05) showing a linear relationship. Screening for trisomy 21 using the 5th percentile as a cut-off value resulted in a sensitivity of 59.1% for a 5.1% false-positive rate. The likelihood ratio was 11.6. Conclusion: Screening for trisomy 21 using fetal nasal bone length measurements showed a sensitivity comparable to that of maternal biochemistry for a given false-positive rate of 5%. Association of nasal bone lengths with other sonographic markers, taking into account the background risk for maternal and gestational age, may further improve sensitivity and reduce false positives, allowing avoidance of unnecessary invasive diagnostic procedures.

AB - Objectives: Fetuses with trisomy 21 typically present with subtle facial abnormalities, including a hypoplastic nasal bone. The aim of this study was to provide a reference range for the length of the fetal nasal bone and to test its value in second-trimester ultrasound screening for trisomy 21. Design: A reference range of fetal nasal booze length was established from cross-sectional data on 1923 consecutive singleton pregnancies scanned at 16-24 weeks' gestation in women older than 35 years. Screening for trisomy 21 was prospectively studied using the measurement o f fetal nasal bone lengths smaller than the 5th percentile as a cut-off value. Results: Follow-up was possible in 1631 cases (84.8%). Trisomy 21 was found in 22 cases (1.35%). Nasal bone length measurement increased as a function of gestational age (P < 0.05) showing a linear relationship. Screening for trisomy 21 using the 5th percentile as a cut-off value resulted in a sensitivity of 59.1% for a 5.1% false-positive rate. The likelihood ratio was 11.6. Conclusion: Screening for trisomy 21 using fetal nasal bone length measurements showed a sensitivity comparable to that of maternal biochemistry for a given false-positive rate of 5%. Association of nasal bone lengths with other sonographic markers, taking into account the background risk for maternal and gestational age, may further improve sensitivity and reduce false positives, allowing avoidance of unnecessary invasive diagnostic procedures.

KW - Chromosomal abnormalities

KW - Fetus

KW - Nasal bone

KW - Trisomy 21

KW - Ultrasound

UR - http://www.scopus.com/inward/record.url?scp=0037295084&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037295084&partnerID=8YFLogxK

U2 - 10.1002/uog.31

DO - 10.1002/uog.31

M3 - Article

C2 - 12601838

AN - SCOPUS:0037295084

VL - 21

SP - 156

EP - 160

JO - Ultrasound in Obstetrics and Gynecology

JF - Ultrasound in Obstetrics and Gynecology

SN - 0960-7692

IS - 2

ER -