title: Nomograms of sonographic measurements throughout gestation of the fetal hard palate width, length and area.
abstract: OBJECTIVE
  To assess the feasibility of sonographic depiction of the fetal hard palate and secondarily to create nomograms throughout gestation of its sonographic width, length and area.
  
  
  METHODS
  This was a cross-sectional study of pregnant patients between 15 and 41 weeks' gestation. Inclusion criteria consisted of well-established dates (confirmed by early ultrasound), and singleton, non-anomalous fetuses. Sonographic measurements obtained included biparietal diameter, head circumference, abdominal circumference and femur length. Fetal hard palate measurements included maximum width, maximum length and the calculated area. Tables were prepared depicting the estimated mean +/- SD and 5(th), 50(th) and 95(th) centiles at each gestational week between 15 and 41 weeks. Pearson's correlation coefficient and associated P-values for the relationships between fetal hard palate measurements and other sonographic measurements and coefficients of variation for each of the fetal hard palate measurements were calculated.
  
  
  RESULTS
  The study included 602 consecutive patients. The mean maternal age was 28.7 +/- 6.3 years, with median gravidity of 2 (range, 1-12) and parity 1 (range, 0-8). All attempts at obtaining fetal hard palate ultrasound measurements were successful. Mean fetal hard palate width (cm) = -0.73579345 + 0.11370432 x GA - 0.00083919 x GA(2) and SD = -0.017842055 + 0.005142475 x GA, where GA is gestational age in weeks. Mean fetal hard palate length (cm) = -0.82020463 + 0.11767777 x GA - 0.00092801 x GA(2) and SD = -0.043064317 + 0.006378869 x GA. Mean fetal hard palate area (cm(2)) = -2.40090641 + 0.17136556 x GA + 0.00097308 x GA(2) and SD = -0.603647741 + 0.040740282 x GA. Sonographic measurements of the fetal hard palate width, length and area correlated significantly and strongly with gestational age (all P < 0.001) and significantly but less strongly with femur length (P = 0.004).
  
  
  CONCLUSIONS
  The fetal hard palate may be depicted sonographically with relative ease between 15 and 41 weeks' gestation and measurements of the fetal hard palate width, length and area correlate well with gestational age, biparietal diameter, abdominal circumference, sonographic estimated fetal weight, and femur length.
authors.affiliation: The Division of Maternal-Fetal Medicine, The Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA. dmsherer@aol.com
authors.forename: D M
authors.initials: DM
authors.lastname: Sherer
authors.forename: M
authors.initials: M
authors.lastname: Sokolovski
authors.forename: P G
authors.initials: PG
authors.lastname: Santoso
authors.forename: M
authors.initials: M
authors.lastname: Dalloul
authors.forename: O
authors.initials: O
authors.lastname: Abulafia
mesh_terms: D000328:Adult; D002972:Cleft Palate / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000196:embryology; D005865:Gestational Age; D006801:Humans; D021362:Palate, Hard / Q000000981:diagnostic imaging* / Q000196:embryology*; D011247:Pregnancy; D011446:Prospective Studies; D012016:Reference Values; D016216:Ultrasonography, Prenatal