Effect of head circumference in combination with facial profile line on ultrasonic diagnosis of microcephaly

Abstract

Objective: Recently, microcephaly has usually been misdiagnosed only by ultrasound via measurement of head circumference (HC). Therefore, the aim of this study is to find another diagnostic index to supplement the original diagnostic method of microcephaly, to improve the detection rate of fetal microcephaly and to reduce the misdiagnosis rate.

Methods: We retrospectively analyzed 123 pregnant women from February 2012 to January 2017 with fetal HC less than two standard deviations (SD). The facial profile line (FPL) was determined by ultrasonography. The first method (M1) was only used HC to determine whether the fetus was microcephaly, the second one (M2) was to combine HC and FPL for the diagnosis of microcephaly. Results were classified into five orderly categories by experienced sonographers. ROC curve was drawn to evaluate the diagnostic effect.

Results: Among the pregnant women, 14 cases of fetal head circumference were less than 3SD, 109 were −2SD < HC≤ −3SD. A total of 12 cases were confirmed of microcephaly by magnetic resonance imaging (MRI) or postnatal, 10 cases of HC were less than 3SD, 2 were −2SD < HC≤ −3SD. The area under the ROC curve for M1 and M2 were 0.751 and 0.983 respectively.

Conclusion: The HC in combination with FPL can be used to evaluate the fetal HC and forehead development quickly, and to improve the sensitivity and specificity of diagnosing fetal microcephaly.

Keywords:

• Facial profile line
• head circumference
• microcephaly
• ROC curve
• ultrasonic diagnosis

Disclosure of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by the Key R & D project of Shandong Province of China (2015GSF118081 and 2016GSF201141).