Frontomaxillary facial angle in trisomy 21 fetuses at 16-24 weeks of gestation

Objectives To establish a normal range for the frontomaxillary facial (FMF) angle by three-dimensional (3D) ultrasound imaging and to examine the FMF angle in trisomy 21 fetuses at 16-24 weeks of gestation. Methods We measured the FMF angle using 3D volumes of the fetal profile obtained with the transducer parallel to the long axis of the nose and at 45 to the palate, which had been acquired from 150 normal fetuses and 23 fetuses with trisomy 21. Results In the normal group there was no significant association between the FMF angle and gestational age; the mean FMF angle was 83.9 (range, 76.9-90.2) and the 95(th) centile was 88.5 degrees. In 15 (65.2%) of the fetuses with trisomy 21 the FMF angle was greater than 88.5 degrees. Repeatability studies demonstrated that in 95% of cases the difference between two measurements of FMF angle by the same operator and different operators was less than 5. Conclusions In the majority of second-trimester fetuses with trisomy 21 the FMF angle is increased.