Ultrasonographic study of fetal facial profile markers during the first trimester

Chunya Ji,Qi Pan,Zhong Yang,Jun Zhang,Xuedong Deng,Qing Liang,Linliang Yin,Xiaoli Jiang

doi:10.1186/s12884-021-03813-6

Chunya Ji, Qi Pan + Show 6 more

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https://doi.org/10.1186/s12884-021-03813-6

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Abstract

BackgroundTo establish reference ranges of fetal facial profile markers and study their correlations with crown-rump length (CRL) during the first trimester (11 ~ 13+ 6 weeks’ gestation) in a Chinese population.MethodsUltrasonographic images of measuring fetal nuchal translucency (NT) were retrospectively selected randomly in normal fetuses whose parents were both Chinese. The facial markers included inferior facial angle (IFA), maxilla-nasion-mandible (MNM) angle, facial maxillary angle (FMA) and profile line (PL) distance. These markers were measured through ViewPoint 6 software by two experienced sonographers.ResultsThree hundred and eighty fetuses were selected. The ICCs (95 % CI) of intra-operator 1 reproducibility of IFA, MNM angle, FMA, PL distance were 0.944 (0.886 ~ 0.973), 0.804 (0.629 ~ 0.902), 0.834 (0.68 ~ 0.918) and 0.935 (0.868 ~ 0.969), respectively. The ICCs (95 % CI) of intra-operator 2 reproducibility of IFA, MNM angle, FMA, PL distance were 0.931 (0.857 ~ 0.967), 0.809 (0.637 ~ 0.904), 0.786 (0.600 ~ 0.892) and 0.906 (0.813 ~ 0.954), respectively. The ICCs (95 % CI) of inter-operator reproducibility of IFA, MNM angle, FMA, PL distance were 0.885 (0.663 ~ 0.953), 0.829 (0.672 ~ 0.915), 0.77 (0.511 ~ 0.891) and 0.844 (0.68 ~ 0.925), respectively. The average ± SD of IFA, MNM angle, FMA and PL distance were 80.2°±7.25°, 4.17°±1.19°, 75.36°±5.31°, 2.78 ± 0.54 mm, respectively. IFA and PL distance significantly decreased with CRL, while MNM angle and FMA significantly increased with CRL.ConclusionsIt was feasible to measure fetal facial markers during the first trimester. In Chinese population, the reference ranges of IFA, MNM angle, FMA and PL distance were 80.2°±7.25°, 4.17°±1.19°, 75.36°±5.31°, 2.78 ± 0.54 mm, respectively, and the measurements were found to correlate with CRL.

Highlights

To establish reference ranges of fetal facial profile markers and study their correlations with crownrump length (CRL) during the first trimester (11 ~ 13+ 6 weeks’ gestation) in a Chinese population
The facial profile line (FPL) [9] was defined as the line that passed through the middle point of the anterior border of the mandible and the nasion
We found that the mean inferior facial angle (IFA) of normal fetuses was 80.2 (SD 7.25) °, and it decreased with CRL

Summary

Introduction

To establish reference ranges of fetal facial profile markers and study their correlations with crownrump length (CRL) during the first trimester (11 ~ 13+ 6 weeks’ gestation) in a Chinese population. Fetal facial markers including inferior facial angle (IFA), maxilla-nasion-mandible (MNM) angle, facial maxillary angle (FMA) and profile line (PL) distance, were measured in fetal facial midsagittal section during the first trimester. The tip of the mentum to the most anterior point of the more protruding lip (Fig. 1). MNM angle [8] was defined as the angle between maxilla-nasion line and mandible-nasion line in the mid-sagittal section (Fig. 2), and the nasion [9] was defined as the most anterior point at the intersection of the frontal and nasal bone. PL distance [9] was the perpendicular distance from the facial profile line (FPL) to the outer border of the forehead (Fig. 4)

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