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First‐trimester hand measurements in euploid and aneuploid human fetuses using virtual reality
Author(s) -
Baken Leonie,
Benoit Bernard,
Koning Anton H. J.,
Willemsen Sten P.,
Spek Peter J.,
SteegersTheunissen Régine P. M.,
Steegers Eric A. P.,
Exalto Niek
Publication year - 2014
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4404
Subject(s) - trisomy , gestational age , first trimester , medicine , fetus , intraclass correlation , aneuploidy , obstetrics , gynecology , pregnancy , ultrasound , reproducibility , crown rump length , andrology , biology , chromosome , mathematics , radiology , genetics , statistics , gene
Objective Although second‐trimester and third‐trimester reference curves for human fetal hand growth allow for identification of several genetic syndromes, little is known about first‐trimester hand growth. We investigated first‐trimester hand growth in euploid and aneuploid fetuses. Method Between 9 and 12 weeks' gestational age (GA), wrist width, hand width, hand length, and hand index were measured in three‐dimensional (3D) ultrasound datasets of 112 euploid and 65 aneuploid pregnancies. We constructed reference curves for these measurements in euploid pregnancies and calculated z ‐scores for measurements in aneuploid pregnancies. Reproducibility was established in a subset of 20 datasets. Results While wrist width, hand width, and hand length increased with gestational age, hand index decreased. Intraobserver and interobserver intraclass correlation coefficient values were >0.97. In trisomy 21 cases, wider wrists and hands were observed compared with euploid pregnancies (mean z ‐scores 1.06, SD 2.04, p < 0.001 and 1.16, SD 1.30, p < 0.001, respectively). Trisomy 18 cases showed narrower and shorter hands (mean z ‐scores −0.74, SD 1.20, p = 0.009 and −0.97, SD 0.86, p = 0.005, respectively). In trisomy 13 cases, no differences were observed. Conclusion Reference values are available for first‐trimester studies on human hand development. First‐trimester hand measurements in trisomies 21 and 18 differ significantly from those in euploid pregnancies and may be useful for early identification of abnormal development. © 2014 John Wiley & Sons, Ltd.