Sonographic visualization of the middle phalanx of the fetal fifth digit between 13 and 17 weeks of gestation.
OBJECTIVE
To assess in utero visualization of the middle phalanx of the fifth digit (MPFD) between 13 and 17 weeks of gestation.


METHODS
This was a prospective cross-sectional study in which women attending for fetal sonographic examination between 13 + 0 and 17 + 6 weeks of gestation were evaluated for the presence of the middle phalanx of the fifth digit (MPFD). A total of 682 fetuses with normal findings on first-trimester anatomical examination were recruited. Using transvaginal multifrequency 4-8 and 5-9 MHz probes, the fifth finger was examined in both axial and lateral views until optimal visualization of the MPFD was achieved.


RESULTS
The MPFD was visualized in 14.3% (2/14) of cases at 13 weeks, 70.3% (154/219) at 14 weeks, 82.2% (240/292) at 15 weeks, 97.4% (111/114) at 16 weeks and 100% (43/43) at 17 weeks of gestation.


CONCLUSIONS
Ultrasound visualization of the MPFD gradually increases during the 13- to 17-week period. This emphasizes the limited role of non-ossification of the MPFD as a sonographic marker of Down syndrome before 17 weeks of gestation.
Zalel
Y
Y
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Israel. zalel_y@netvision.net.il
Achiron
R
R
Kivilevitch
Z
Z
D003430:Cross-Sectional Studies; D004314:Down Syndrome / Q000000981:diagnostic imaging*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D050278:Finger Phalanges / Q000000981:diagnostic imaging* / Q000196:embryology; D005865:Gestational Age; D006801:Humans; D010012:Osteogenesis; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D016216:Ultrasonography, Prenatal / Q000379:methods