{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:56:13Z","timestamp":1791381373313,"version":"4.3.3"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2019YFE0198300"],"award-info":[{"award-number":["2019YFE0198300"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004853","name":"Chinese University of Hong Kong","doi-asserted-by":"publisher","award":["2025.164"],"award-info":[{"award-number":["2025.164"]}],"id":[{"id":"10.13039\/501100004853","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004853","name":"Chinese University of Hong Kong","doi-asserted-by":"publisher","award":["2024.157"],"award-info":[{"award-number":["2024.157"]}],"id":[{"id":"10.13039\/501100004853","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the genetic etiologies and clinical significance of fetal tympanic ring abnormalities detected during second\u2010trimester ultrasound in the absence of microtia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Between November 2019 and June 2024, we examined the fetal tympanic rings of 10,277 unselected pregnant women during the 20\u201322\u00a0weeks of morphology ultrasound. Fetal cases with abnormal tympanic rings, without microtia, underwent amniocentesis for genetic investigation, including chromosome microarray analysis and trio genome sequencing (30\u00d7).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five fetuses (0.05%, 5\/10,277) with abnormal tympanic rings in the absence of microtia were identified in this cohort, including three unilaterally (2 right, 1 left) and two bilaterally affected cases. Four fetuses had no other obvious structural abnormalities. One had an isolated unilateral hypoplastic tympanic ring with negative genetic findings and was postnatally found to have conductive hearing loss. The remaining four fetuses were diagnosed with severe early\u2010onset genetic disorders (80%), including KBG syndrome, Noonan syndrome, Saethre\u2010Chotzen syndrome, and Cornelia de Lange syndrome. All these four pregnancies were terminated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ultrasound evaluation of fetal tympanic ring abnormalities is feasible during the second trimester. Fetal tympanic ring anomalies even occurring with minor ultrasound markers may represent a significant indication for a comprehensive genetic assessment. More studies are needed to establish how tympanic ring anomalies should be integrated into routine clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.70131","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T04:16:59Z","timestamp":1774498619000},"page":"1096-1103","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prenatal Tympanic Ring Anomaly Without Microtia: A Subtle Clue Toward Severe Early\u2010Onset Monogenic Disorders"],"prefix":"10.1002","volume":"46","author":[{"given":"Yung Hang","family":"Lam","sequence":"first","affiliation":[{"name":"Private Clinic Central  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengmeng","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"CUHK\u2010BCM Joint Centre for Medical Genetics The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3626-6500","authenticated-orcid":false,"given":"Zirui","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"CUHK\u2010BCM Joint Centre for Medical Genetics The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwong Wai","family":"Choy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"CUHK\u2010BCM Joint Centre for Medical Genetics The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tak Yeung","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"CUHK\u2010BCM Joint Centre for Medical Genetics The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5712-1968","authenticated-orcid":false,"given":"Ye","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"CUHK\u2010BCM Joint Centre for Medical Genetics The Chinese University of Hong Kong  Hong Kong SAR 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