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First‐trimester crown–rump length and embryonic volume of aneuploid fetuses measured in virtual reality
Author(s) -
Baken L.,
van Heesch P. N. A. C. M.,
Wildschut H. I. J.,
Koning A. H. J.,
van der Spek P. J.,
Steegers E. A. P.,
Exalto N.
Publication year - 2013
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.12365
Subject(s) - monosomy , fetus , trisomy , aneuploidy , medicine , crown rump length , gestational age , andrology , intrauterine growth restriction , gynecology , obstetrics , pregnancy , first trimester , biology , karyotype , chromosome , genetics , gene
Objectives To examine whether embryonic volume ( EV ), as measured using three‐dimensional ( 3D ) ultrasound and a virtual reality approach, is a better measure of growth restriction than is crown–rump length ( CRL ) in aneuploid fetuses. Methods We retrospectively measured CRL and EV in prospectively collected 3D ultrasound volumes of 55 aneuploid fetuses using the Barco I‐Space VR system. The gestational age ranged from 11 + 2 to 14 + 4 weeks. We compared our measured data with previously published reference curves for euploid fetuses. Delta‐values were calculated by subtracting the expected mean for euploid fetuses of the same gestational age from observed values. The one‐sample t ‐test was used to test the significance of differences observed. Results The CRL measurements of fetuses with trisomy 21 ( n = 26), trisomy 13 ( n = 5) and monosomy X ( n = 5) were comparable with those of euploid fetuses, but in fetuses with trisomy 18 ( n = 19) the CRL was 14.5% smaller ( P < 0.001). The EV in fetuses with trisomies 21, 18 and 13 and monosomy X was smaller than in euploid fetuses (–27.8%, P < 0.001; –39.4%, P < 0.001; –40.9%, P = 0.004; and –27.3%, P = 0.055, respectively). Conclusions When relying on CRL measurements alone, first‐trimester growth restriction is especially manifest in trisomy 18. Using EV , growth restriction is also evident in trisomies 21 and 13 and monosomy X. EV seems to be a more effective measurement for the assessment of first‐trimester growth restriction in aneuploid fetuses. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.