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Related Concept Videos

Cranial Bones: Lateral View01:27

Cranial Bones: Lateral View

The lateral view of the cranium is dominated by temporal, sphenoid, and ethmoid bones.
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...

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First-trimester screening with nasal bone in twins.

Jane Cleary-Goldman1, Andrei Rebarber, David Krantz

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Adding nasal bone examination to first-trimester screening significantly improves Down syndrome detection rates in twins. This enhances diagnostic accuracy for high-risk pregnancies, aiding crucial patient decisions.

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Area of Science:

  • Maternal-Fetal Medicine
  • Prenatal Diagnostics
  • Genetics

Background:

  • First-trimester screening is crucial for identifying fetal aneuploidies.
  • Twin pregnancies present unique challenges in prenatal screening.
  • Accurate Down syndrome detection is vital for informed reproductive choices.

Purpose of the Study:

  • To assess the effectiveness of first-trimester screening for Down syndrome in twin pregnancies.
  • To determine the detection rate at a 5% screen-positive rate.
  • To evaluate the added value of nasal bone examination in this screening protocol.

Main Methods:

  • Retrospective analysis of 2094 twin pregnancies (4188 fetuses) from August 2005 to July 2007.
  • Utilized first-trimester screening markers: nuchal translucency, nasal bone, pregnancy-associated plasma protein-A, and free beta-hCG.
  • Employed the Fetal Medicine Foundation twin algorithm for risk calculation, simulating affected and unaffected cases at 12 weeks gestation.

Main Results:

  • The inclusion of nasal bone examination, alongside nuchal translucency, PAPP-A, and free beta-hCG, increased the Down syndrome detection rate.
  • Detection rates rose from 79% to 89% while maintaining a 5% screen-positive rate.
  • The study analyzed data from 2094 twin pregnancies, encompassing 4188 fetuses.

Conclusions:

  • First-trimester screening for Down syndrome in twins is significantly enhanced by the inclusion of nasal bone assessment.
  • Improved detection rates empower high-risk twin pregnancies with better decision-making regarding invasive testing.
  • This non-invasive approach aids in managing the risks associated with invasive procedures.