{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:36:07Z","timestamp":1780731367892,"version":"3.54.1"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,3,4]],"date-time":"2013-03-04T00:00:00Z","timestamp":1362355200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2013,3]]},"abstract":"ABSTRACT<\/jats:title>Objective<\/jats:title>To evaluate the prefrontal space ratio (PFSR<\/jats:styled-content>) in second\u2010 and third\u2010trimester euploid fetuses and fetuses with trisomy 21.<\/jats:p><\/jats:sec>Methods<\/jats:title>This was a retrospective study utilizing stored mid\u2010sagittal two\u2010dimensional images of second\u2010 and third\u2010trimester fetal faces that were recorded during prenatal ultrasound examinations at the Department of Prenatal Medicine at the University of Tuebingen, Germany and at a private center for prenatal medicine in Nuremberg, Germany. For the normal range, 279 euploid pregnancies between 15 and 40 weeks' gestation were included. The results were compared with 91 cases with trisomy 21 between 15 and 40 weeks. For the ratio measurement, a line was drawn between the leading edge of the mandible and the maxilla (MM<\/jats:styled-content> line) and extended in front of the forehead. The ratio of the distance between the leading edge of the skull and the leading edge of the skin (d1) to the distance between the skin and the point where the MM<\/jats:styled-content> line was intercepted (d2) was calculated. The PFSR<\/jats:styled-content> was determined by dividing d2 by d1.<\/jats:p><\/jats:sec>Results<\/jats:title>In the euploid and trisomy 21 groups, the median gestational age at the time of ultrasound examination was 21.1 (range, 15.0\u201340.0) and 21.4 (range, 15.0\u201340.3) weeks, respectively. Multiple regression analysis showed that PFSR<\/jats:styled-content> was independent of maternal and gestational age. In the euploid group, the mean PFSR<\/jats:styled-content> was 0.97 \u00b1 0.29. In fetuses with trisomy 21, the mean PFSR<\/jats:styled-content> was 0.2 \u00b1 0.38 (P<\/jats:italic> < 0.0001). The PFSR<\/jats:styled-content> was below the 5th<\/jats:sup> centile in 14 (5.0%) euploid fetuses and in 72 (79.1%) fetuses with trisomy 21.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The PFSR<\/jats:styled-content> is a simple and effective marker in second\u2010 and third\u2010trimester screening for trisomy 21. Copyright \u00a9 2012 ISUOG. Published by John Wiley & Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.12261","type":"journal-article","created":{"date-parts":[[2012,7,13]],"date-time":"2012-07-13T08:25:58Z","timestamp":1342167958000},"page":"262-266","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Prefrontal space ratio in second\u2010 and third\u2010trimester screening for trisomy 21"],"prefix":"10.1002","volume":"41","author":[{"given":"B.","family":"Yazdi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Tuebingen Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Sonek","sequence":"additional","affiliation":[{"name":"Fetal Medicine Foundation USA, Dayton, OH, USA and Division of Maternal Fetal Medicine Wright State University Dayton OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Oettling","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Tuebingen Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Hoopmann","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Tuebingen Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Abele","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Tuebingen Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Schaelike","sequence":"additional","affiliation":[{"name":"Center for Prenatal Diagnosis and Genetics Nuremberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. 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