{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T13:29:47Z","timestamp":1765546187826,"version":"3.37.3"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,1,25]],"date-time":"2017-01-25T00:00:00Z","timestamp":1485302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Audit the crown\u2010rump length (CRL) measurements taken at 11 to 13 weeks scan, using operator\u2010specific median multiples of the median (MoM) for pregnancy\u2010associated plasma protein\u2010A (PAPP\u2010A) and free <jats:italic>\u03b2<\/jats:italic>\u2010human chorionic gonadotropin (<jats:italic>\u03b2<\/jats:italic>\u2010hCG) plots, to identify deviations potentially related to a systematic CRL bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Study population included consecutive singleton pregnancies undergoing first trimester combined screening, scanned by sonologists with at least 100 scans, during the 2011 to 2012 period. Previously described plots for PAPP\u2010A and <jats:italic>\u03b2<\/jats:italic>\u2010hCG median MoM points, with their 95% confidence intervals circles, in relation with the expected deviation line were used. These plots have been modified to adjust the deviation line to the sonologist\u2010specific expected MoM variation for each CRL millimetre bias according to each sonologist\u2010specific median gestational ages at both blood sampling and ultrasound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010eight sonologists performing 9472 scans were included, accounting for 36% of the 77 sonologists and 70% of the 13\u2009643 scans initially considered. Mean gestational age was 10\u2009+\u20092\u2009weeks at blood sampling and 12\u2009+\u20094\u2009weeks at ultrasound. Fifteen sonologists (53%) did not demonstrate any CRL bias, 10 (36%) present with a significant CRL underestimation, being above 2\u2009mm in 6 (21%), and in 3 (11%) the observed deviation could not be explained by a systematic CRL bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In sonologists with more than 100 NT measurements, operator\u2010specific PAPP\u2010A and <jats:italic>\u03b2<\/jats:italic>\u2010hCG median MoM plots are able to identify deviations potentially related to a systematic CRL bias. Systematic underestimation above 2\u2009mm was observed in 1\/5 of them. \u00a9 2016 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.4996","type":"journal-article","created":{"date-parts":[[2016,12,24]],"date-time":"2016-12-24T12:28:42Z","timestamp":1482582522000},"page":"229-234","source":"Crossref","is-referenced-by-count":4,"title":["Crown\u2010rump length audit plots with the use of operator\u2010specific PAPP\u2010A and <i>\u03b2<\/i>\u2010hCG median MoM"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8154-9323","authenticated-orcid":false,"given":"Joan","family":"Sabria","sequence":"first","affiliation":[{"name":"BCNatal \u2014 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Sant Joan de D\u00e9u and Hospital Cl\u00ednic) University of Barcelona  Barcelona Spain"},{"name":"RETICS funded by the PN I\u2009+\u2009D\u2009+\u2009I 2008\u20132011 (Spain), ISCIII\u2010 Sub\u2010Directorate General for Research Assessment and Promotion and the European Regional Development Fund (ERDF), Ref. RD12\/0026.  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Guirado","sequence":"additional","affiliation":[{"name":"BCNatal \u2014 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Sant Joan de D\u00e9u and Hospital Cl\u00ednic) University of Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Mir\u00f3","sequence":"additional","affiliation":[{"name":"BCNatal \u2014 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Sant Joan de D\u00e9u and Hospital Cl\u00ednic) University of Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Dolors","family":"G\u00f3mez\u2010Roig","sequence":"additional","affiliation":[{"name":"BCNatal \u2014 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Sant Joan de D\u00e9u and Hospital Cl\u00ednic) University of Barcelona  Barcelona Spain"},{"name":"RETICS funded by the PN I\u2009+\u2009D\u2009+\u2009I 2008\u20132011 (Spain), ISCIII\u2010 Sub\u2010Directorate General for Research Assessment and Promotion and the European Regional Development Fund (ERDF), Ref. RD12\/0026.  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoni","family":"Borrell","sequence":"additional","affiliation":[{"name":"BCNatal \u2014 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Sant Joan de D\u00e9u and Hospital Cl\u00ednic) University of Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,1,25]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1975.tb00710.x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000454932.15177.be"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11095"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6370"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6371"},{"key":"e_1_2_5_7_1","unstructured":"NHS FASP(2010)Recommended criteria for measurement of fetal crown rump length (CRL) as part of combined screening for Trisomy 21 within the NHS in England. 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