{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:45:51Z","timestamp":1760013951222},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,1,8]],"date-time":"2015-01-08T00:00:00Z","timestamp":1420675200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2015,2]]},"abstract":"ABSTRACT<\/jats:title>Objectives<\/jats:title>To evaluate nasal bone length (NBL<\/jats:styled-content>), prenasal thickness (PT<\/jats:styled-content>), prenasal thickness\u2010to\u2010nasal bone length (PT\u2010NBL<\/jats:styled-content>) ratio and prefrontal space ratio (PFSR<\/jats:styled-content>) as markers for Down syndrome in the second and third trimesters.<\/jats:p><\/jats:sec>Methods<\/jats:title>NBL<\/jats:styled-content>, PT<\/jats:styled-content>, PT\u2010NBL<\/jats:styled-content> ratio and PFSR<\/jats:styled-content> were measured retrospectively in stored two\u2010dimensional images or three\u2010dimensional volumes (corrected to the mid\u2010sagittal plane) of fetuses with Down syndrome, which were retrieved from the digital databases of participating units. Measurements were performed on the stored images and volumes by two experienced operators, and the values obtained were compared to our previously reported normal ranges for euploid fetuses in order to assess the detection rates for Down syndrome.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 159 fetuses with Down syndrome were included in the analysis, six of which were excluded because of inadequate available images. Median maternal age was 36.0 years and median gestational age was 23\u2009+\u20091 weeks. NBL<\/jats:styled-content> and PT<\/jats:styled-content> were correlated with gestational age (P<\/jats:italic>\u2009<\u20090.001), but the PT\u2010NBL<\/jats:styled-content> ratio and PFSR<\/jats:styled-content> were not. Mean NBL<\/jats:styled-content>, PT<\/jats:styled-content>, PT\u2010NBL<\/jats:styled-content> ratio and PFSR<\/jats:styled-content> were 4.42 mm, 5.56 mm, 1.26 and 0.34, respectively. The nasal bone was absent in 23 (15.4%) cases. As a marker for Down syndrome, the PT\u2010NBL<\/jats:styled-content> ratio yielded the highest detection rate (86.2%), followed by PFSR<\/jats:styled-content> (79.7%), PT<\/jats:styled-content> (63.4%) and NBL<\/jats:styled-content> (61.9%). All markers were abnormal in 33.6% of cases, whilst all were normal in 4.7%. At least one of the four markers was abnormal in 95.3%, and either the PT\u2010NBL<\/jats:styled-content> ratio or PFSR<\/jats:styled-content> was abnormal in 93.8%. Detection rates were not related to gestational age.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The PT\u2010NBL<\/jats:styled-content> ratio and PFSR<\/jats:styled-content> are robust second\u2010 and third\u2010trimester markers for Down syndrome. Both provide high detection rates and are easy to use, as the cut\u2010off for normality is constant throughout gestation. Copyright \u00a9 2014 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.13391","type":"journal-article","created":{"date-parts":[[2014,4,21]],"date-time":"2014-04-21T10:54:43Z","timestamp":1398077683000},"page":"211-216","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Nasal bone length, prenasal thickness, prenasal thickness\u2010to\u2010nasal bone length ratio and prefrontal space ratio in second\u2010 and third\u2010trimester fetuses with Down syndrome"],"prefix":"10.1002","volume":"45","author":[{"given":"F. I.","family":"Vos","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, Department of Obstetrics and Gynaecology University Medical Centre Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. A. P.","family":"De Jong\u2010Pleij","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology St Antonius Hospital Nieuwegein The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Bakker","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Department of Obstetrics and Gynaecology University Medical Centre Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Tromp","sequence":"additional","affiliation":[{"name":"Department of Statistics St Antonius Hospital Nieuwegein The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Pajkrt","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Department of Obstetrics and Gynaecology Academic Medical Centre Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. O.","family":"Kagan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Tuebingen Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. M.","family":"Bilardo","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Department of Obstetrics and Gynaecology University Medical Centre Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,1,8]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"259","article-title":"Observations on an ethnic classification of idiots","volume":"3","author":"Down JLH","year":"1866","journal-title":"Lond Hosp Reports"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2841"},{"key":"e_1_2_5_4_1","first-page":"487","article-title":"Neck edema. An echographic sign of trisomy 21 in pregnancy","volume":"43","author":"Serville F","year":"1986","journal-title":"Arch Fr Pediatr"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1089"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12364"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5404"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002470050675"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004290050123"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06709-5"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2002.21.12.1387"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10058"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.9047"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11120"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12261"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1979.tb127276.x"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.119082"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1207"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.2009.107"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19970627)70:4<421::AID-AJMG17>3.0.CO;2-J"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1159\/000350271"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2183"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8929"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2009.05.009"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4001"}],"container-title":["Ultrasound in Obstetrics & Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.13391","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.13391","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T05:08:48Z","timestamp":1696482528000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.13391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1,8]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015,2]]}},"alternative-id":["10.1002\/uog.13391"],"URL":"https:\/\/doi.org\/10.1002\/uog.13391","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1,8]]},"assertion":[{"value":"2014-01-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-04-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-01-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}