A model for second-trimester Down syndrome sonographic screening based on facial landmarks and digit length measurement.
Ultrasound Obstet Gynecol
; 27(3): 290-5, 2006 Mar.
Article
en En
| MEDLINE
| ID: mdl-16302282
ABSTRACT
OBJECTIVE:
To determine whether Down syndrome can be detected by combining measurements of fetal nasal bone (NB) length, prenasal thickness (PT) and digits 2 and 3 of the hand.METHODS:
Two hundred and fifty-four normal and 25 Down-syndrome fetuses were scanned between 15 and 33 weeks' gestation. Physicians performing the scans were not blinded to the fetal karyotype. Both PT and NB were measured in a mid-sagittal plane. For PT measurement calipers were placed between the frontonasal angle and the outer skin edge. Digits 2 and 3 of one hand were also measured. The results (except for PT/NB ratio) were expressed in multiples of the normal gestation-specific median (MoM). A logistic regression model was used to estimate the odds of the fetus having Down syndrome given different combinations of NB, PT, PT/NB ratio, and digits 2 and 3 measurements. The odds were used to calculate the risk of Down syndrome for each pregnant woman from her age and measurements.RESULTS:
The median PT MoM for unaffected fetuses and Down-syndrome fetuses was 1.12 vs. 1.35 (P < 0.0001). The median NB MoM for unaffected and Down-syndrome fetuses was 1.03 vs. 0.81 (P < 0.001) and the PT/NB ratio MoM for unaffected and Down-syndrome fetuses was 0.63 vs. 0.96 (P < 0.001). The respective median MoM values for digits 2 and 3 of the Down-syndrome fetuses were significantly smaller (0.81 vs. 0.93 and 0.89 vs. 0.95, respectively, P = 0.003). Only the PT/NB ratio and digit 2 were finally included in the logistic regression equation. Using a 1 in 200 risk cut-off, the observed sensitivity and false-positive rate were 76% and 6.7%, respectively.CONCLUSION:
Combining the PT/NB ratio and digit 2 measurements yielded a promising screening detection rate. Confirmation of our findings in a prospective study is needed before the method can be used clinically.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Síndrome de Down
/
Dedos
/
Hueso Nasal
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Límite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Ultrasound Obstet Gynecol
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
GINECOLOGIA
/
OBSTETRICIA
Año:
2006
Tipo del documento:
Article
País de afiliación:
Israel