{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T10:21:50Z","timestamp":1772706110224,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,3,13]],"date-time":"2019-03-13T00:00:00Z","timestamp":1552435200000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Compare the performance of first trimester ultrasound biparietal diameter (BPD) screening for open spina bifida (OSB) when BPD is adjusted for crown\u2010rump length (CRL) or abdominal circumference (AC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For 63 OSB and 24\u00a0265 unaffected pregnancies, BPD was expressed as multiple of the normal median (MoM) based on CRL and on AC, and as the ratio BPD\/AC. Screening performance was assessed by the Mahalanobis distance, the observed detection rate with normal fifth and 10th percentile cut\u2010offs and the area under the receiver\u2010operator characteristic curve (AUC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mahalanobis distance for BPD MoM was considerably higher when based on AC than on CRL: 1.69 versus 1.14. Screening performance was also higher: using a fifth percentile cut\u2010off, the detection rate was 59% compared with 41%; using a 10th percentile cut\u2010off, the rates were 63% and 51%. Whilst the false\u2010positives rates were slightly higher too\u20145.3% versus 5.1% and 10.8% versus 9.9%\u2014the AUC was statistically significantly higher: 0.872 (95% CI, 0.816\u20100.928) compared with 0.735 (95% CI, 0.664\u20100.806). BPD\/AC had intermediate performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The best results are obtained when AC, rather than CRL, is used to express BPD values in MoMs. First trimester OSB screening can detect half to two\u2010thirds of cases.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.5433","type":"journal-article","created":{"date-parts":[[2019,2,5]],"date-time":"2019-02-05T17:07:18Z","timestamp":1549386438000},"page":"314-318","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Spina bifida screening in the first trimester using ultrasound biparietal diameter measurement adjusted for crown\u2010rump length or abdominal circumference"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5236-8112","authenticated-orcid":false,"given":"Seshadri","family":"Suresh","sequence":"first","affiliation":[{"name":"Department of Fetal Medicine Mediscan Systems and Fetal Care Research Foundation  Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh","family":"Sudarshan","sequence":"additional","affiliation":[{"name":"Department of Fetal Medicine Mediscan Systems and Fetal Care Research Foundation  Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthi","family":"Rangaraj","sequence":"additional","affiliation":[{"name":"Department of Fetal Medicine Mediscan Systems and Fetal Care Research Foundation  Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh","family":"Indrani","sequence":"additional","affiliation":[{"name":"Department of Fetal Medicine Mediscan Systems and Fetal Care Research Foundation  Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard","family":"Cuckle","sequence":"additional","affiliation":[{"name":"Reproductive Epidemiology Leeds Screening Centre  Leeds UK"},{"name":"Department of Obstetrics and Gynecology Columbia University Medical Center  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7329"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8994"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10111"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12463"},{"issue":"2","key":"e_1_2_6_6_1","first-page":"151","article-title":"Detection of spina bifida by first trimester screening\u2013results of the prospective multicenter Berlin IT\u2010study","volume":"38","author":"Chen FC","year":"2017","journal-title":"Ultraschall Med"},{"issue":"306","key":"e_1_2_6_7_1","first-page":"e1","article-title":"Screening for fetal spina bifida by ultrasound examination in the first trimester of pregnancy using fetal biparietal diameter","volume":"207","author":"Bernard J\u2010P","year":"2012","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11175"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.05.024"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12420"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13406"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15992"},{"issue":"8026","key":"e_1_2_6_13_1","first-page":"1323","article-title":"UK Collaborative AFP Study. 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