{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T10:33:40Z","timestamp":1790332420537,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,3,3]],"date-time":"2015-03-03T00:00:00Z","timestamp":1425340800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:title><jats:styled-content style=\"fixed-case\">ABSTRACT<\/jats:styled-content><\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>In the first trimester of pregnancy, a biparietal diameter (<jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>) below the 5<jats:sup>th<\/jats:sup> percentile is a simple marker that enables the prenatal detection of half of all cases of open spina bifida. We hypothesized that relating the <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content> measurement to the transverse abdominal diameter (<jats:styled-content style=\"fixed-case\">TAD<\/jats:styled-content>) might be another simple and effective screening method. In this study we assessed the performance of using the <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">TAD<\/jats:styled-content> ratio during the first trimester of pregnancy in screening for open spina bifida.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 20\u2009551 first\u2010trimester ultrasound scans (11\u201313 weeks' gestation), performed between 2000 and 2013, were analyzed retrospectively; there were 26 cases of open spina bifida and 17\u2009665 unaffected pregnancies with a crown\u2013rump length of 45\u201384\u2009mm and a record of both <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">TAD<\/jats:styled-content> measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean (\u00b1\u2009<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">TAD<\/jats:styled-content> ratio was 1.00\u2009\u00b1\u20090.06 for fetuses with spina bifida and 1.13\u2009\u00b1\u20090.06 for those without (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). A <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content> \u2264\u20095<jats:sup>th<\/jats:sup> percentile enabled the prenatal detection of 46.2% of spina bifida cases, while a <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">TAD<\/jats:styled-content> ratio of\u2009\u2264\u20091.00 detected 69.2%. If we considered cases in which either <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content> was \u2264\u20095<jats:sup>th<\/jats:sup> percentile or <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">TAD<\/jats:styled-content> ratio was \u2264\u20091, we identified 76.9% of cases. In the latter case, the false\u2010positive rate was 5.1%, while that for using a combination of both <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content> \u2264\u20095<jats:sup>th<\/jats:sup> percentile and <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">TAD<\/jats:styled-content> ratio\u2009\u2264\u20091 was 0.6%, with a sensitivity of 38.5%. The positive predictive value of using a combination of <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>\u2009\u2264\u20095<jats:sup>th<\/jats:sup> percentile and <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">TAD<\/jats:styled-content> ratio\u2009\u2264\u20091 for detecting spina bifida was 8.5%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Between 11 and 13 weeks' gestation, relating <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content> to <jats:styled-content style=\"fixed-case\">TAD<\/jats:styled-content> improves  considerably the diagnostic performance of using <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content> measurement alone in screening for open spina bifida. Screening using this marker is simple and applicable to a large population. Copyright \u00a9 2014 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.13406","type":"journal-article","created":{"date-parts":[[2014,5,10]],"date-time":"2014-05-10T14:06:55Z","timestamp":1399730815000},"page":"267-272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Biparietal\/transverse abdominal diameter ratio\u2009\u2264\u20091: potential marker for open spina bifida at 11\u201313\u2010week scan"],"prefix":"10.1002","volume":"45","author":[{"given":"E. G.","family":"Simon","sequence":"first","affiliation":[{"name":"University Hospital Center of Tours Department of Obstetrics, Gynecology and Fetal Medicine  Tours France"},{"name":"Inserm U930 Fran\u00e7ois Rabelais University  Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. J.","family":"Arthuis","sequence":"additional","affiliation":[{"name":"University Hospital Center of Tours Department of Obstetrics, Gynecology and Fetal Medicine  Tours France"},{"name":"Inserm U930 Fran\u00e7ois Rabelais University  Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Haddad","sequence":"additional","affiliation":[{"name":"University Hospital Center of Tours Department of Obstetrics, Gynecology and Fetal Medicine  Tours France"},{"name":"Coll\u00e8ge Fran\u00e7ais d'Echographie F\u0153tale (CFEF)  Chateaubriant France"},{"name":"Mosa\u00efque Sant\u00e9 Center  La Chauss\u00e9e St Victor France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Bertrand","sequence":"additional","affiliation":[{"name":"University Hospital Center of Tours Biostatistics Department  Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Perrotin","sequence":"additional","affiliation":[{"name":"University Hospital Center of Tours Department of Obstetrics, Gynecology and Fetal Medicine  Tours France"},{"name":"Inserm U930 Fran\u00e7ois Rabelais University  Tours France"},{"name":"Coll\u00e8ge Fran\u00e7ais d'Echographie F\u0153tale (CFEF)  Chateaubriant France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,3,3]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)91610-7"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(88)90218-9"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.171.1.2648467"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(90)90378-K"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(80)91090-9"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.188.1.7685528"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1997.10060406.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11156"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7552"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7329"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10111"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10128"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11079"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12463"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8957"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.9067"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12302"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7718"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10118"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8994"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1980.tb04522.x"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1980.tb04453.x"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2002.00660.x"},{"key":"e_1_2_5_25_1","doi-asserted-by":"crossref","unstructured":"BernardJ\u2010P CuckleHS StirnemannJJ SalomonLJ VilleY. 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