{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:29:08Z","timestamp":1757701748765},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,7,2]],"date-time":"2015-07-02T00:00:00Z","timestamp":1435795200000},"content-version":"vor","delay-in-days":1,"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":[[2015,7]]},"abstract":"ABSTRACT<\/jats:title>Objectives<\/jats:title>To evaluate nasal bone length (NBL<\/jats:styled-content>), maxilla\u2013nasion\u2013mandible (MNM<\/jats:styled-content>) angle, fetal profile (FP<\/jats:styled-content>) line, prenasal thickness (PT<\/jats:styled-content>), prenasal thickness to nasal bone length (PT<\/jats:styled-content>:NBL<\/jats:styled-content>) ratio and prefrontal space ratio (PFSR<\/jats:styled-content>) as markers of trisomy 18 in the second and third trimesters of pregnancy.<\/jats:p><\/jats:sec>Methods<\/jats:title>The NBL<\/jats:styled-content>, MNM<\/jats:styled-content> angle, FP<\/jats:styled-content> line, PT<\/jats:styled-content>, PT<\/jats:styled-content>:NBL<\/jats:styled-content> ratio and PFSR<\/jats:styled-content> were measured retrospectively from stored two\u2010dimensional images or three\u2010dimensional volumes of trisomy\u201018 fetuses, and were compared with our previously reported normal ranges for euploid fetuses. Additional ultrasound findings were noted at initial routine second\u2010trimester scan and at subsequent advanced ultrasound examination performed after referral for karyotyping.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 43 trisomy\u201018 fetuses were included in the analysis. At initial examination, median gestational age was 21\u2009+\u20092\u2009weeks. NBL<\/jats:styled-content> and PT<\/jats:styled-content> were correlated with gestational age (P<\/jats:italic>\u2009<\u20090.001), but the other markers were not. Mean NBL<\/jats:styled-content>, MNM<\/jats:styled-content> angle, PT<\/jats:styled-content>, PT<\/jats:styled-content>:NBL<\/jats:styled-content> ratio and PFSR<\/jats:styled-content> were 3.76\u2009mm, 16.67\u00b0, 4.25\u2009mm, 1.39 and 0.87, respectively. The FP<\/jats:styled-content> line was zero (normal) in 53.7% of cases and negative (abnormal) in 46.3%. All markers were significantly associated with trisomy 18, with the PT<\/jats:styled-content>:NBL<\/jats:styled-content> ratio yielding the highest detection rate (88.4%) followed by NBL<\/jats:styled-content> (83.7%), MNM<\/jats:styled-content> angle (56.4%), FP<\/jats:styled-content> line (46.3%), PT<\/jats:styled-content> (27.9%) and the PFSR<\/jats:styled-content> (20.5%) (for a 5% false\u2010positive rate for the continuous variables). Various combinations of the four best markers (NBL<\/jats:styled-content>, FP<\/jats:styled-content> line, MNM<\/jats:styled-content> angle and PT<\/jats:styled-content>:NBL<\/jats:styled-content> ratio) yielded detection rates of between 72% and 95%. Structural anomalies were not detected in 22% of fetuses at the initial scan and in 2% at the advanced scan.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The PT<\/jats:styled-content>:NBL<\/jats:styled-content> ratio and NBL<\/jats:styled-content> are robust second\u2010 and third\u2010trimester markers for trisomy 18. A negative FP<\/jats:styled-content> line has a 0% false\u2010positive rate and the potential to differentiate between trisomy 18 and Down syndrome, as in the latter the FP<\/jats:styled-content> line is often positive. No major anomaly was observed at the initial scan in about a quarter of trisomy\u201018 fetuses, underlining the role of second\u2010trimester facial marker evaluation. Copyright \u00a9 2014 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.14662","type":"journal-article","created":{"date-parts":[[2014,9,5]],"date-time":"2014-09-05T10:33:51Z","timestamp":1409913231000},"page":"66-72","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Facial profile markers in second\u2010 and third\u2010trimester fetuses with trisomy 18"],"prefix":"10.1002","volume":"46","author":[{"given":"F. I.","family":"Vos","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, University Medical Centre Groningen University of Groningen Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. A. 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