{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:27:46Z","timestamp":1763036866051},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,7,2]],"date-time":"2015-07-02T00:00:00Z","timestamp":1435795200000},"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;amp; Gyne"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the use of the maxilla\u2013nasion\u2013mandible (<jats:styled-content style=\"fixed-case\">MNM<\/jats:styled-content>) angle and fetal profile (<jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content>) line to assess the degree of midfacial hypoplasia in Down\u2010syndrome fetuses in the second and third trimesters of pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">MNM<\/jats:styled-content> angle and <jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content> line were measured retrospectively in stored two\u2010dimensional images or three\u2010dimensional volumes of fetuses with Down syndrome. Data collected from January 2006 to July 2013 were retrieved from the digital databases of participating units. The <jats:styled-content style=\"fixed-case\">MNM<\/jats:styled-content> angle was expressed as a continuous variable (degrees) and the <jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content> line as positive, negative or zero. Measurements were obtained from stored images in the midsagittal plane by two experienced examiners and compared with our previously reported normal ranges for euploid fetuses. A <jats:styled-content style=\"fixed-case\">MNM<\/jats:styled-content> angle below the 5<jats:sup>th<\/jats:sup> centile of the reference range and a positive or negative <jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content> line were considered as abnormal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 133 fetuses with Down syndrome were available for analysis, eight of which were subsequently excluded because of inadequate images. The <jats:styled-content style=\"fixed-case\">MNM<\/jats:styled-content> angle was not influenced by gestational age (<jats:italic>P<\/jats:italic>\u2009=\u20090.48) and was significantly smaller in Down\u2010syndrome fetuses than in euploid fetuses (mean, 12.90\u00b0 <jats:italic>vs<\/jats:italic> 13.53\u00b0, respectively; <jats:italic>P<\/jats:italic>\u2009=\u20090.015). The <jats:styled-content style=\"fixed-case\">MNM<\/jats:styled-content> angle was below the 5<jats:sup>th<\/jats:sup> centile for euploid fetuses in 16.8% of fetuses with Down syndrome (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). In the cohort of Down\u2010syndrome fetuses, a positive <jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content> line was present in 41.6% of cases (with a false\u2010positive rate (<jats:styled-content style=\"fixed-case\">FPR<\/jats:styled-content>) of 6.3%) and was positively correlated with Down syndrome and gestational age (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). There was no case with a negative <jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content> line. In cases of Down syndrome, a positive <jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content> line was correlated with a small <jats:styled-content style=\"fixed-case\">MNM<\/jats:styled-content> angle (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A small <jats:styled-content style=\"fixed-case\">MNM<\/jats:styled-content> angle and a positive <jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content> line can be regarded as novel markers for Down syndrome. The <jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content> line is an easy marker to measure, has a low <jats:styled-content style=\"fixed-case\">FPR<\/jats:styled-content>, does not require knowledge of normal reference values and has the potential to differentiate between Down syndrome and trisomy 18, as, in the latter, the <jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content> line is often negative. Copyright \u00a9 2014 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.14720","type":"journal-article","created":{"date-parts":[[2014,11,4]],"date-time":"2014-11-04T07:15:46Z","timestamp":1415085346000},"page":"168-173","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Fetal facial profile markers of Down syndrome in the second and third trimesters of pregnancy"],"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. 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, University Medical Centre Groningen University of Groningen  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":"K. O.","family":"Kagan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of T\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. 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