{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T21:05:41Z","timestamp":1778015141499,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2009,12,15]],"date-time":"2009-12-15T00:00:00Z","timestamp":1260835200000},"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":[[2010,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To validate a new sonographic technique for the display and measurement of fetal iliac crest angle (ICA), and to determine the relative contribution of standardized fetal pelvic measurements for estimating risk of Down syndrome during the second trimester of pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three\u2010dimensional ultrasonography of the fetal pelvis was performed during a second\u2010trimester scan for genetic amniocentesis. A coronal view of the \u2018virtual pelvis\u2019 was obtained by applying a maximum intensity projection algorithm to visualize both iliac wings. Two different ICAs were measured from a coronal projection of the fetal pelvis (ICA\u2010coronal 1 and ICA\u2010coronal 2); the latter approach relied on using ischial tuberosities as reference landmarks. Next, a coronal projection of the fetal pelvis was rotated to demonstrate a rendered view of the axial fetal pelvis. Axial inner (ICA\u2010inner), middle (ICA\u2010middle) and outer (ICA\u2010outer) ICAs were measured. The maximum anterior iliac distance measurement was defined as the widest separation between the most anterior points of the rendered iliac crests. The reproducibility of each ICA method was analyzed using Bland\u2013Altman statistics. Simple and multiple logistic regression analysis determined the relative contribution of each parameter as a prenatal predictor of Down syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010four normal fetuses and 19 fetuses with Down syndrome were examined. The ICA\u2010middle and ICA\u2010coronal 2 parameters were the most reproducible angle measurements. The mean \u00b1 SD ICA\u2010middle measurement for fetuses with Down syndrome was significantly greater than that for normal subjects (94.5 \u00b1 9.8\u00b0 vs. 83.1 \u00b1 6.5\u00b0; <jats:italic>P<\/jats:italic> &lt; 0.001). The mean \u00b1 SD ICA\u2010coronal 2 angle measurement for fetuses with Down syndrome was slightly greater than that for normal subjects (57.9 \u00b1 5.5\u00b0 vs. 51.9 \u00b1 7.1\u00b0; <jats:italic>P<\/jats:italic> = 0.0014). A multiple logistic regression model including ICA\u2010middle and ICA\u2010coronal 2 provided a predictive ability of 88.1% based on the area under the receiver\u2013operating characteristics curve. This combination had a sensitivity of 94.4% for a false\u2010positive rate of 5% in the detection of Down syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Standardized iliac crest measurements of the fetal pelvis can be used to identify some fetuses at risk for trisomy 21 during the second trimester of pregnancy. Copyright \u00a9 2009 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.7477","type":"journal-article","created":{"date-parts":[[2009,12,15]],"date-time":"2009-12-15T12:07:07Z","timestamp":1260878827000},"page":"163-171","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Iliac crest angle: a novel sonographic parameter for the prediction of Down syndrome risk during the second trimester of pregnancy"],"prefix":"10.1002","volume":"35","author":[{"given":"W.","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Balasubramaniam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Yeo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. 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