Abstract
Amaç: Etnik farklılıklar gösteren ve kromozomal anomalilerle ilişkisi bildirilen fetal nazal kemik uzunluğunun 18+0-23+6. gebelik haftaları arasındaki nomogramlarının oluşturulmasıdır.
Materyal ve Metod: Ocak 2009-Eylül 2014 tarihleri arasında, 18+0-23+6 gebelik haftalarında, US bulguları normal olan ve doğum sonrası anomali saptanmayan 2653 fetus retrospektif olarak değerlendirildi. Detaylı fetal anomali taraması yapılan her fetusun biparietal çapı (BPD), kafa çevresi (HC), karın çevresi (AC), femur uzunluğu (FL), nazal kemik (NK) uzunluğu ve ortalama gebelik haftası (GH) kaydedildi. NK uzunlukları ile GH, BPD, HC, AC ve FL arasında korelasyon analizi yapıldı. Her gebelik haftası için 5-10-25-50-75-90-95. persentil değerleri hesaplandı.
Bulgular: Çalışmaya dahil edilen 2626 gebenin 27’sinda ikiz gebelik saptandı. Gebelerin yaşları 17-46 yıl (30,02 ± 5,78 yıl) arasındaydı. Çalışmamızda, 18 ile 23. gebelik hafta arasında sırasıyla 159, 214, 528, 599, 563, 583 fetus mevcuttu ve fetal NK uzunluğu ortalama değerleri sırasıyla 5,5 ±0,85; 6,3±0,83; 6,6±0,81; 6,9±1; 7,1±0,86; 7,6±0,89 (minimum 4 mm ve maksimum 10,1 mm) olarak bulundu. NK uzunlukları GH, BPD, HC, AC ve FL artışı ile lineer olarak arttı. Korelasyon analizinde fetal NK uzunluğu GH, BPD, HC, AC ve FL ile anlamlı pozitif korele bulundu (p<0,001).
Sonuç: Çalışmamızda bölgemize ait 18+0-23+6. gebelik haftalarında sağlıklı fetuslarda nazal kemik uzunluğu nomogramları oluşturduk. Bu referans değerlerin, prenatal taramada nazal kemik hipoplazisi tanısında kullanılabileceğini düşünmekteyiz.
Keywords
References
- Sandikcioglu M, Molsted K, Kjaer I. Development of the Human Nasal and Vomeral Bones. J Craniofac Genet Dev Biol 1994; 14: 124-34.
- Larose C, Massoc P, Hillion Y, Bernard JP, Ville Y. Comparison of fetal nasal bone assessment by ultrasound at 11-14 weeks and by postmortem X-ray in trisomy 21: a prospective observational study. Ultrasound Obstet Gynecol 2003; 22: 27-30.
- Cicero S, Sonek J, McKenna D, Croom C, Johnson L, Nicolaides K. Nasal bone hypoplasia in trisomy 21 at 15-22 weeks of gestation. Ultrasound Obstet Gynecol 2002; 21: 15-8.
- Bromley B, Lieberman E, Shipp TD, ve ark. 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, ve ark. 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.
- Benoit B, Chaoui R. Three-dimensional ultrasound with maximal mode rendering: a novel technique for the diagnosis of bilateral or unilateral absence or hypoplasia of nasal bones in second-trimester screening for Down syndrome. Ultrasound Obstet Gynecol 2005; 25: 19-24.
- Vintzileos A, Walters C, Yeo L. Absent nasal bone in the prenatal detection of fetuses with trisomy 21 in a high-risk population. Obstet Gynecol 2003; 101: 905-8.
- Gámez F, Ferreiro P, Salmeán JM. Ultrasonographic measurement of fetal nasal bone in a low-risk population at 19–22 gestational weeks. Ultrasound Obstet Gynecol 2004; 23: 152–3.
- Sonek D, Mckenna D, Webb D, Croom C, Nicolaides K. Nasal bone length throughout gestation: normal ranges based on 3537 fetal ultrasound measurements. Ultrasound in Obstetrics and Gynecology 2003; 21: 152-5.
- Tran LT, Carr DB, Mitsumori LM, ve ark. 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, ve ark. Fetal nasal bone length: reference range and clinical application in ultrasound screening for Trisomy 21, Ultrasound Obstet Gynecol 2003; 21: 156–160.
- Bromley B, Benacerraf BR. The genetic sonogram scoring index. Semin Perinatol 2003; 27: 124–9.
- Gian ferrari EA, Benn PA, Dries L, Brault K, Egan JF, Zelop CM. Absent or shortened nasal bone length and the detection of Down Syndrome in second-trimester fetuses. Obstet Gynecol 2007; 109: 371-5.
- Xie HN, Zhu YX, Li LJ, He H. Ultrasonographic fetal nasal bone assessment in prenatal screening for Down syndrome. Zhonghua Fu Chan Ke Za Zhi 2008; 43: 171–4.
- Jung E, Won HS, Lee PR, Kim A. Ultrasonographic measurement of fetal nasal bone length in the second trimester in Korean population. Prenat Diagn 2007; 27: 154–7.
- Zelop CM, Milewski E, Brault K, Benn P, Borgida AF, Egan JF. Variation of fetal nasal bone length in second-trimester fetuses according to race and ethnicity. J Ultrasound Med 2005; 24: 1487–9.
- Chen M, Lee CP, Leung KY, Hui PW, Tang MH. Pilot study on the midsecond trimester examination of fetal nasal bone in the Chinese population. Prenat Diagn 2004; 24: 87–91.
- Kanagawa T, Fukuda H, Kinugasa Y, Son M, Shimoya K, Murata Y. Mid-second trimester measurement of fetal nasal bone length in the Japanese population. J Obstet Gynaecol Res 2006; 32: 403–7.
- Chiu WH, Tung TH, Chen YS, ve ark. Normative curves of fetal nasal bone length for the ethnic Chinese population. Ir J Med Sci 2011; 180: 73–7.
- Goynumer G, Arisoy R, Yayla M, Erdogdu E, Ergin N. Fetal nasal bone length during the second trimester of pregnancy in a Turkish population. Eur J Obstet Gynecol Reprod Biol 2014; 176: 96-8.
- Dizen P, Asal N, Kaçar M, ve ark. İkinci trimester gebeliklerde fetal nazal kemik uzunluğunun değerlendirilmesi. S.D.Ü Sağlık Bilimleri Enstitüsü Dergisi 2013; 4: 3.
- Arısoy R, Ergin N, Yayla M, Göynümer G. Biparietal Çapın Burun Kemiği Uzunluğuna Oranı. Perinatoloji Dergisi 2010; 18: 3.
- Yalınkaya A, Güzel A, Uysal E, Kangal K, Kaya Z.Gebelik Haftalarına Göre Fetal Nazal Kemik Uzunluğu Nomogramı. Perinatoloji Dergisi 2009; 17: 8.
- 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.
- Yayla M, Uysal E, Bayhan G, ve ark. Gebelikte nazal kemik gelişimi ve ultrasonografi ile değerlendirilmesi. Ultrasonografi Obstetrik ve Jinekoloji 2003; 7: 20–4.
Abstract
Purpose: To establish the nomograms of fetal nasal bone length reported the ethnic differences and relationship between chromosomal abnormalities, between 18+0-23+6 gestational weeks.
Material and Method: In this study, 2653 fetus between 18+0-23+6 gestational weeks had normal US findings and had not postnatal anomaly were retrospectively evaluated between January 2009 and September 2014. After detailed fetal anomaly scan, biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), nasal bone (NB) length and mean gestational weeks (GW) of each fetus were recorded. Regression analyses were performed between NB length and GW, BPD, HC, AC and FL. The reference values for 5-10-25-50-75-90-95. percentiles were established for each gestational week.
Results: In this study, 27 twin pregnancies were detected in the 2626 pregnant women (age range, 17–46 years; mean age, 30.02 ±5.78 years). There were 159, 214, 528, 599, 563, 583 fetuses and the mean NB lengths were 5.5 ± 0.85, 6.3 ± 0.83, 6.6 ± 0.81, 6.9 ± 1, 7.1 ± 0.86, 7.6 ± 0.89 (minimum 4 mm and maximum 10.1 mm) between 18+0-23+6 gestational weeks, respectively. NB length was increased linearly consistent with GH, BPD, HC, AC and FL during 18+0-23+6 gestational weeks. In correlation analysis, the fetal NB length were significantly correlated with GW, BPD, HC, AC and FL (p<0.001).
Conclusion: In our study, we established the NB length nomogram in healthy fetuses between 18+0-23+6 gestational weeks. We think that this reference values can be used for diagnosis of nasal bone hypoplasia in prenatal screening.
Keywords
References
- Sandikcioglu M, Molsted K, Kjaer I. Development of the Human Nasal and Vomeral Bones. J Craniofac Genet Dev Biol 1994; 14: 124-34.
- Larose C, Massoc P, Hillion Y, Bernard JP, Ville Y. Comparison of fetal nasal bone assessment by ultrasound at 11-14 weeks and by postmortem X-ray in trisomy 21: a prospective observational study. Ultrasound Obstet Gynecol 2003; 22: 27-30.
- Cicero S, Sonek J, McKenna D, Croom C, Johnson L, Nicolaides K. Nasal bone hypoplasia in trisomy 21 at 15-22 weeks of gestation. Ultrasound Obstet Gynecol 2002; 21: 15-8.
- Bromley B, Lieberman E, Shipp TD, ve ark. 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, ve ark. 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.
- Benoit B, Chaoui R. Three-dimensional ultrasound with maximal mode rendering: a novel technique for the diagnosis of bilateral or unilateral absence or hypoplasia of nasal bones in second-trimester screening for Down syndrome. Ultrasound Obstet Gynecol 2005; 25: 19-24.
- Vintzileos A, Walters C, Yeo L. Absent nasal bone in the prenatal detection of fetuses with trisomy 21 in a high-risk population. Obstet Gynecol 2003; 101: 905-8.
- Gámez F, Ferreiro P, Salmeán JM. Ultrasonographic measurement of fetal nasal bone in a low-risk population at 19–22 gestational weeks. Ultrasound Obstet Gynecol 2004; 23: 152–3.
- Sonek D, Mckenna D, Webb D, Croom C, Nicolaides K. Nasal bone length throughout gestation: normal ranges based on 3537 fetal ultrasound measurements. Ultrasound in Obstetrics and Gynecology 2003; 21: 152-5.
- Tran LT, Carr DB, Mitsumori LM, ve ark. 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, ve ark. Fetal nasal bone length: reference range and clinical application in ultrasound screening for Trisomy 21, Ultrasound Obstet Gynecol 2003; 21: 156–160.
- Bromley B, Benacerraf BR. The genetic sonogram scoring index. Semin Perinatol 2003; 27: 124–9.
- Gian ferrari EA, Benn PA, Dries L, Brault K, Egan JF, Zelop CM. Absent or shortened nasal bone length and the detection of Down Syndrome in second-trimester fetuses. Obstet Gynecol 2007; 109: 371-5.
- Xie HN, Zhu YX, Li LJ, He H. Ultrasonographic fetal nasal bone assessment in prenatal screening for Down syndrome. Zhonghua Fu Chan Ke Za Zhi 2008; 43: 171–4.
- Jung E, Won HS, Lee PR, Kim A. Ultrasonographic measurement of fetal nasal bone length in the second trimester in Korean population. Prenat Diagn 2007; 27: 154–7.
- Zelop CM, Milewski E, Brault K, Benn P, Borgida AF, Egan JF. Variation of fetal nasal bone length in second-trimester fetuses according to race and ethnicity. J Ultrasound Med 2005; 24: 1487–9.
- Chen M, Lee CP, Leung KY, Hui PW, Tang MH. Pilot study on the midsecond trimester examination of fetal nasal bone in the Chinese population. Prenat Diagn 2004; 24: 87–91.
- Kanagawa T, Fukuda H, Kinugasa Y, Son M, Shimoya K, Murata Y. Mid-second trimester measurement of fetal nasal bone length in the Japanese population. J Obstet Gynaecol Res 2006; 32: 403–7.
- Chiu WH, Tung TH, Chen YS, ve ark. Normative curves of fetal nasal bone length for the ethnic Chinese population. Ir J Med Sci 2011; 180: 73–7.
- Goynumer G, Arisoy R, Yayla M, Erdogdu E, Ergin N. Fetal nasal bone length during the second trimester of pregnancy in a Turkish population. Eur J Obstet Gynecol Reprod Biol 2014; 176: 96-8.
- Dizen P, Asal N, Kaçar M, ve ark. İkinci trimester gebeliklerde fetal nazal kemik uzunluğunun değerlendirilmesi. S.D.Ü Sağlık Bilimleri Enstitüsü Dergisi 2013; 4: 3.
- Arısoy R, Ergin N, Yayla M, Göynümer G. Biparietal Çapın Burun Kemiği Uzunluğuna Oranı. Perinatoloji Dergisi 2010; 18: 3.
- Yalınkaya A, Güzel A, Uysal E, Kangal K, Kaya Z.Gebelik Haftalarına Göre Fetal Nazal Kemik Uzunluğu Nomogramı. Perinatoloji Dergisi 2009; 17: 8.
- 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.
- Yayla M, Uysal E, Bayhan G, ve ark. Gebelikte nazal kemik gelişimi ve ultrasonografi ile değerlendirilmesi. Ultrasonografi Obstetrik ve Jinekoloji 2003; 7: 20–4.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original article |
| Authors | |
| Publication Date | December 1, 2019 |
| Published in Issue | Year 2019 Volume: 11 Issue: 4 |
e-ISSN: 2548-0251
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