Objective: The posterior fossa of normal fetuses was evaluated and compared with those having chromosomal abnormalities at 11-13+6 weeks' gestation in Chinese population. Methods: In 518 normal fetuses referred to first trimester screening, fetal brain stem (BS) and brain stem to occipital bone distance (BSOB) were measured prospectively. The BS and BSOB were also measured on stored images in fetuses with confirmed trisomy 21 (n = 38), Trisomy 18 (n = 26), Trisomy 13 (n = 8), and monosomy X (n = 8). Results: The BS diameter and BSOB distance correlated linearly with fetal crown-rump length (CRL) by regression analysis. The BS to BSOB ratio was below the 5th percentile in 2 (5.26%), 11 (44%), 4 (50%) and 4 (50%) fetuses with trisomy 21, trisomy 18, trisomy 13 and monosomy X, respectively. Thus, both BS and BS/BSOB ratio were significantly lower in trisomy 18, trisomy 13 and monosomy X fetuses when compared to the reference range but not in fetuses with Trisomy 21. Conclusion: In ultrasound scans performed at the 11-13+6 gestation weeks, fetuses with trisomy 18, 13, and monosomy X had lower BS/BSOB ratios. But trisomy 21 fetuses did not show significant differences in posterior fossa compared to the normal population.

1.
Hsiao CH, Cheng PJ, Shaw SW, Hsu JJ, Chen RC, Tseng YJ, Chu WC: Extended first-trimester screening using multiple sonographic markers and maternal serum biochemistry: a five-year prospective study. Fetal Diagn Ther 2014;35:296-301.
2.
Snijders RJ, Noble P, Sebire N, et al: UK multicentre project on assessment of risk of trisomy 21 by maternal age and fetal nuchal-translucency thickness at 10-14 weeks of gestation. Fetal Medicine Foundation First Trimester Screening Group. Lancet 1998;352:343-346.
3.
Kagan KO, Wright D, Baker A, et al: Screening for trisomy 21 by maternal age, fetal nuchal translucency thickness, free beta-human chorionic gonadotropin and pregnancy-associated plasma protein-A. Ultrasound Obstet Gynecol 2008;31:618-624.
4.
Souka AP, Pilalis A, Kavalakis Y, et al: Assessment of fetal anatomy at the 11- to 14-week ultrasound examination. Ultrasound Obstet Gynecol 2004;24:730-734.
5.
Grande M, Arigita M, Borobio V, et al: First-trimester detection of structural abnormalities and the role of aneuploidy markers. Ultrasound Obstet Gynecol 2012;39:157-163.
6.
Chaoui R, Nicolaides KH: From nuchal translucency to intracranial translucency towards the early detection of spina bifida. Ultrasound Obstet Gynecol 2010;35:133-138.
7.
Chaoui R, Nicolaides KH: Detecting open spina bifida at the 11- to 13-week scan by assessing intracranial translucency and the posterior brain region: mi-sagittal or axial plane? Ultrasound Obstet Gynecol 2011;38:609-612.
8.
Lachmann R, Chaoui R, Moratalla J, et al: Posterior brain in fetuses with open spina bifida at 11 to 13 weeks. Prenat Diagn 2011;31:103-106.
9.
Scheier M, Lachmann R, Petros M, et al: Three-dimensional sonography of the posterior fossa in fetuses with open spina bifida at 11-13 weeks' gestation. Ultrasound Obstet Gynecol 2011;38:625-629.
10.
Papastefanou I, Souka AP, Pilalis A, et al: Fetal intracranial translucency and cisterna magna at 11 to 14 weeks: reference ranges and correlation with chromosomal abnormalities. Prenat Diagn 2011;31:1189-1192.
11.
Ferreira AF, Syngelaki A, Smolin A, et al: Posterior brain in fetuses with trisomy 18, trisomy 13 and triploidy at 11 to 13 weeks' gestation. Prenat Diagn 2012;32:854-858.
12.
Robinson HP, Fleming JE: A critical evaluation of sonar ‘crown rump length' measurements. Br J Obstet Gynecol 1975;82:702-710.
13.
The Fetal Medicine Foundation: http://www.fetalmedicine.com/fmf/online-education/01-11-136-week-scan/ (accessed June 5, 2011).
14.
Grandjean H, Larroque D, Levi S, et al: The performance of routine ultrasonographic screening of pregnancies in the Eurofetus Study. Am J Obstet Gynecol 1999;181:446-454.
15.
International Society of Ultrasound in Obstetrics & Gynecology Education Committee: Sonographic examination of the fetal central nervous system: guidelines for performing the ‘basic examination' and the ‘fetal neurosonogram'. Ultrasound Obstet Gynecol 2007;29:109-116.
16.
Egle D, Strobl I, Weiskopf-Schwendinger V, et al: Appearance of the fetal posterior fossa at 11 + 3 to 13 + 6 gestational weeks on transabdominal ultrasound examination. Ultrasound Obstet Gynecol 2011;38:620-624.
17.
Garcia-Posada R, Eixarch E, Sanz M, et al: Cisterna magna width at 11-13 weeks in the detection of posterior fossa anomalies. Ultrasound Obstet Gynecol 2013;41:515-520.
18.
Ghi T, Pilu G, Falco P, et al: Prenatal diagnosis of open and closed spina bifida. Ultrasound Obstet Gynecol 2006;28:899-903.
19.
Nizard J, Bernard JP, Ville Y: Fetal cystic malformations of the posterior fossa in the first trimester of pregnancy. Fetal Diagn Ther 2005;20:146-151.
20.
Inagaki M, Ando Y, Mito T, et al: Comparison of brain imaging and neuropathology in cases of trisomy 18 and 13. Neuroradiology 1987;29:474-479.
21.
Loureiro T, Ferreira AF, Ushakov F, et al: Dilated fourth ventricle in fetuses with trisomy 18, trisomy 13 and triploidy at 11-13 weeks' gestation. Fetal Diagn Ther 2012;32:186-189.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.