Fetal Nasal Bone Length Evaluation in Second Trimester Pregnancies

Year 2013, Volume: 4 Issue: 3, 111 - 116, 10.12.2013

Neşe Asal , Pelin Dizen Mahmut Kaçar Ömer Yılmaz , Elif Ünlü , Seyit Köse Pınar Koşar

Abstract

Abstract
Aim: Nasal bone length of fetuses (NBL) in second trimester by measuring during routine obstetric sonography examination to determine the range of normal value for Turk society.

Method: A total of 16-22 week gestational aged 250 healthy fetuses nasal bone lenght was measured with transabdominal ultrasonography.

Results: Measurement of nasal bone lenght of 16, 17, 18, 19, 20, 21 and 22 week gestational aged fetuses were calculated respectively as: 2.9–4.6 mm, 3.3–5.1 mm, 3.4–7.3 mm, 4.3–6.6 mm, 4.8–7.3 mm, 4.6–7.5 mm, 5.6–7.2 mm (average of 5,4 mm ± 0.87).

Conclusion: Nasal bone lenght of 16-22 week gestational aged fetuses were calculated as 2.9-7.5 mm. It should be considered as normal in this range. Nasal bone lenght of second trimester fetuses under 2.9 mm should be evaluated for fetal anomalies.

KeyWords: Nasal bone, Ultrasound, Down's syndrome

Keywords

Nasal bone, ultrasound, down’s syndrome

İkinci Trimester Gebeliklerde Fetal Nazal Kemik Uzunluğunun Değerlendirilmesi

Abstract

Amaç: İkinci trimesterdeki fetüslerin nazal kemik uzunluklarını (NKU) rutin obstetrik sonografi incelemesi sırasında ölçerek Türk toplumu için normal değer aralığını belirlemek.
Gereç ve Yöntem: Çalışmaya 16–22 gebelik haftalarında 250 gebeye ait 250 sağlıklı fetus dahil edildi. Fetüsler General Electronic marka Logiq S6 model ultrasonografi cihazı ile 3.5 MHz konveks transduser kullanılarak transabdominal bakı ile değerlendirildi. Fetüslerın rutin ikinci trimester obstetrik incelemesi yapıldı ve sonografik olarak sağlıklı olduğu tespit edilen fetusların NKU'ları ölçüldü.
Bulgular: NKU ölçümü 16. haftada 2.9–4.6 mm, 17. haftada 3.3–5.1 mm, 18. haftada 3.4–7.3 mm, 19. haftada 4.3–6.6 mm, 20. haftada 4.8–7.3 mm, 21. haftada 4.6–7.5 mm, 22. haftada 5.6–7.2 mm (ortalama 5.4 mm ± 0.87) olarak hesaplandı.
Sonuçlar: Çalışmamızın sonucunda 16–22 gebelik haftalarında normal fetal NKU ölçümünü 2.9 ile 7.5 mm arası olarak hesaplandı. Bu nedenle 16-22 gebelik haftalarında NKU için 2.9 mm'nin altındaki değerler fetal anomali açısından araştırılmalıdır.
Anahtar Kelimeler: Nazal kemik, Ultrasonografi, Down sendromu

Keywords

Nazal kemik, ultrasonografi, down sendromu

References

• Hagen SL. Textbook of diagnostic ultrasonography. Mosby. USA. Tanısal ultrasonografi. 5. Baskı, Çeviri editörü: Akhan O. Güneş Kitabevi, 2. Cilt. 2005; 590–625.
• Keeling JW, Hansen BF, KjaerI. Pattern of malformations in the axial skeleton in human trisomy 21 fetuses. Am J Med Genet. 1997; 11: 68: 466–471.
• Stempfle N, Huten Y, Fredouille C, et al. Skeletal abnormalities in fetuses with Down’s syndrome: a radiographic post-mortem study. Pediatr Radiol. 1999; 29: 682–688.
• Cicero S, Curcio P, Papageorghiou A, et al. Absence of nasal bone in fetuses with trisomy 21 at 11–14 weeks of gestation: an observational study. Lancet. 2001; 17: 358: 1665–1667.
• Sonek JD, Nicolaides KH. Prenatal ultrasonographic diagnosis of nasal bone abnormalities in three fetuses with Down syndrome. Am J Obstet Gynecol. 2002; 186: 139-141.
• Odibo AO, Sehdev HM, Dunn L, McDonald R, Macones GA. The association between fetal nasal bone hypoplasia and aneuploidy. Obstet Gynecol. 2004; 104: 1229–1233.
• Guis F, Ville Y, Vincent Y, et al. Ultrasound evaluation of the length of the fetal nasal bones throughout gestation. Ultrasound Obstet Gynecol. 1995; 5: 304–307.
• Yayla M, Göynümer G, Uysal Ö. Fetal burun kemiği uzunluğu nomogramı. Perinatoloji Dergisi. 2006; 14: 77–82.
• Sonek JD, Mckenna D, Webb D, et al. Nasal bone length throughout gestation: normal ranges based on 3537 fetal ultrasound measurement. Ultrasound Obstet Gynecol. 2003; 21: 152–155.
• Orlandi F, Bilardo CM, Campogrande M, et al. Measurement of nasal bone length at 11–14 weeks of pregnancy and its potential role in Down syndrome risk assessment. Ultrasound Obstet Gynecol. 2003; 22: 36–39.
• Yayla M, Uysal E, Bayhan G, et al. Gebelikte nazal kemik gelişimi ve ultrasonografi ile değerlendirilmesi. Ultrasonografi Obstetrik ve Jinekoloji . 2003; 7: 20–24.
• Bromley B, Benacerraf BR. The genetic sonogram scoring index. Semin Perinatol. 2003; 27: 124–129.
• Bromley B, Lieberman E, Shipp TD, et al. Fetal nose bone length: a marker for Down syndrome in the second trimester. J Ultrasound Med. 2002; 21: 1387–1394.
• Cusick W, Provenzano J, Sullivan CA, et al. Fetal nasal bone length in euploid and aneuploid fetuses between 11 and 20 weeks’ gestation: a prospective study, J Ultrasound Med. 2004; 23: 1327–1333.
• Tran LT, Carr DB, Mitsumori LM, et al. Second-trimester biparietal diameter/nasal bone length ratio is an independent predictor of trisomy 21.J Ultrasound Med. 2005; 24: 805–810.
• Bunduki V, Ruano J, Miguelez J, et al. Fetal nasal bone length: reference range and clinical application in ultrasound screening for Trisomy 21, Ultrasound Obstet Gynecol . 2003; 21: 156–160.
• Gamez F, Ferreiro P, Salmean J.M. Ultrasonographic measurement of fetal nasal bone in a low risk population at 19–22 gestational weeks, Ultrasound Obstet Gynecol . 2004; 23: 152–153.
• Orlandi F, Rossi C, Orlandi E, et al. First-trimester screening for trisomy-21 using a simplified method to assess the presence or absence of the fetal nasal bone, Am J Obstet Gynecol. 2005; 192: 1107–1111.
• Cicero S, Rembouskos G, Vandecruys H, et al. Likelihood ratio for Trisomy 21 in fetuses with absent nasal bone at the 11–14 weeks scan. Ultrasound Obstet Gynecol. 2004; 23: 218–223.
• Viora E, Errante G, Sciarrone A, et al. Fetal nasal bone and trisomy 21 in the second trimester. Prenat Diagn. 2005; 25: 511–515.
• Sutthibenjakul S, Suntharasaj T, Suwanrath C, et al. A Thai reference for normal fetal nasal bone length at 15 to 23 weeks gestation. J Ultrasound Med. 2009; 28: 49–53.
• Hung JH, Fu CY, Chen CY, et al. Fetal nasal bone length and Down syndrome during the second trimester in a Chinese population. J Obstet Gynaecol Res. 2008; 34: 518–523.
• Shin JS, Yang JH, Chung JH, et al. The relation between fetal nasal bone length and biparietal diameter in the Korean population. Prenat Diagn. 2006; 26: 321–323.
• Kanagawa T, Fukuda H, Kinugasa Y, et al. Mid-second trimester measurement of fetal nasal bone length in the Japanese population. J Obstet Gynecol Res. 2006; 32: 403– 40
• Zelop CM, Milewski E, Brault K, et al. Variation of fetal nasal bone in second-trimester fetuses according to race and ethnicity. J Utrasound Med. 2005; 24: 1487–1489.
• Yalınkaya A, Güzel Aİ, Uysal E, et al. Gebelik haftalarına göre fetal nazal kemik uzunluğu nomogramı. Perinatoloji Der. 2009; 17: 100–103.