{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T08:41:21Z","timestamp":1765528881982,"version":"3.48.0"},"reference-count":25,"publisher":"Walter de Gruyter GmbH","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_dx-2021-0007_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Quality control of ultrasonography markers is necessary to ensure greater efficacy of prenatal aneuploidy screening. The aim of this study was to assess the quality of the crown-rump length (CRL) and nuchal translucence (NT) measurement accuracy by the laboratory according to quality indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_dx-2021-0007_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Retrospective observational study on 4,908 single-foetus pregnant women who underwent prenatal aneuploidy screening in the first trimester of pregnancy. Euploid foetuses with CRL between 45 and 84\u00a0mm were included, while those with NT\u22653.5\u00a0mm were excluded. CRL measurement was considered to be accurate if the median multiples of the median (MoM) for pregnancy-associated plasma protein A (PAPP-A) was between 0.90 and 1.10. Fifteen sonographers participated in the study, six of whom comprised the control group. Systematic error for a sonographer was considered when CRL measurement was greater than \u00b12\u00a0mm with respect to the control group. Quality for NT was assured by means of the WHIRI method and each sonographer\n                      <jats:italic>cumulative sum control chart<\/jats:italic>\n                      (CUSUM).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_dx-2021-0007_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For CRL accuracy, five sonographers underestimated the measurements, while another four overestimated them, with no statistical differences. For smaller sized foetuses, all sonographers met the established specifications. Regarding NT control, three sonographers did not meet the quality criteria for the median MoM. All sonographers met the specifications for the logarithmic standard deviation of the NT MoM levels. Thirteen sonographers met the CUSUM specifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_dx-2021-0007_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Evaluation of a quality control of ultrasonography parameters by laboratory professionals is necessary to avoid under- or overestimation tendencies for CRL and NT measurements. CUSUM is a useful tool for the immediate correction of errors in NT measurements.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/dx-2021-0007","type":"journal-article","created":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T18:17:10Z","timestamp":1622917030000},"page":"115-121","source":"Crossref","is-referenced-by-count":0,"title":["Quality control of ultrasonography markers for Down\u2019s syndrome screening: a retrospective study by the laboratory"],"prefix":"10.1515","volume":"12","author":[{"given":"Blanca","family":"Badal","sequence":"first","affiliation":[{"name":"Laboratory Medicine Department , Hospital Universitari Son Espases , Palma de Mallorca , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonieta","family":"Ballesteros","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department , Hospital Universitari Son Espases , Palma de Mallorca , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Crespo","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department , Hospital Universitari Son Espases , Palma de Mallorca , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Morell-Garcia","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department , Hospital Universitari Son Espases , Palma de Mallorca , Spain"},{"name":"Institut de Recerca Sanit\u00e0ria de les Illes Balears (IdISBa) , Palma de Mallorca , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep Miquel","family":"Bau\u00e7\u00e0","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department , Hospital Universitari Son Espases , Palma de Mallorca , Spain"},{"name":"Institut de Recerca Sanit\u00e0ria de les Illes Balears (IdISBa) , Palma de Mallorca , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Pastor","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department , Hospital Universitari Son Espases , Palma de Mallorca , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Ruiz de Gopegui","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Department , Hospital Universitari Son Espases , Palma de Mallorca , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inmaculada","family":"Mart\u00edn","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department , Hospital Universitari Son Espases , Palma de Mallorca , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2021,6,4]]},"reference":[{"key":"2025121207265966060_j_dx-2021-0007_ref_001","doi-asserted-by":"crossref","unstructured":"Palomaki, GE, Lee, JE, Canick, JA, Mc Dowell, GA, Donnenfeld, AE. ACMG Laboratory Quality Assurance Committee Technical standards and guidelines: prenatal screening for Down syndrome that includes first-trimester biochemistry and\/or ultrasound measurements. Genet Med 2009;11:669\u201381. https:\/\/doi.org\/10.1097\/gim.0b013e3181ad5246.","DOI":"10.1097\/GIM.0b013e3181ad5246"},{"key":"2025121207265966060_j_dx-2021-0007_ref_002","doi-asserted-by":"crossref","unstructured":"Sagi-Dain, L, Peleg, A, Shlomi, S. First-trimester crown-rump length and risk of chromosomal aberrations-A systematic review and meta-analysis. Obstet Gynecol Surv 2017;72:603\u20139. https:\/\/doi.org\/10.1097\/ogx.0000000000000490.","DOI":"10.1097\/OGX.0000000000000490"},{"key":"2025121207265966060_j_dx-2021-0007_ref_003","doi-asserted-by":"crossref","unstructured":"Robinson, HP, Fleming, JE. A critical evaluation of sonar \u201ccrown-rump length\u201d measurements. 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