Pilot study on the midsecond trimester examination of fetal nasal bone in the Chinese population

Hypoplasia of the nasal bone of fetuses affected by trisomy 21 and other aneuploidies could be detected by prenatal ultrasound examination and was an important new marker in the detection of Down syndrome in the second trimester. Racial differences in fetal nasal bone length have been reported. However, there was no reference range for the fetal nasal bone length (NBL) in the Chinese population. We conducted a pilot study to investigate the reproducibility of the measurement of fetal NBL in the mid second trimester and to determine whether there is any difference in NBL between the Chinese and the Caucasian population.

From June 2002 to February 2003, 198 Chinese women were examined. Ultrasound measurements of NBL were performed on a strictly midsagittal plane in normal singleton fetuses at 15 to 23 weeks' gestation.

The mean difference in the NBL between the two investigators was small (mean = 0.043 mm; 95% CI, -0.033 to 0.12), and there was substantial agreement between the measurements for each observer. Limits of agreement were -0.48 to 0.35 and -0.29 to 0.22 mm in the two investigators respectively. It was found that the median length of the nasal bones increased from 3.5 mm at 15 weeks to 6.7 mm at 23 weeks' gestation. There was a linear relationship between the length of the nasal bone and the gestational age.

It was demonstrated that the measurement of nasal bone length was feasible and reproducible in the second trimester. The fetal nasal bone length in Chinese population appeared shorter than that of Caucasian and African-Americans. There is a need to establish a reference range of fetal NBL for the Chinese population.