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Ultraschall Med 2023; 44(01): e25-e38
DOI: 10.1055/a-1408-1998
Review

Reference Ranges for Vermis Biometry on Prenatal Ultrasound: Systematic Review and Meta-Analysis

Referenzbereiche für die Biometrie des Vermis cerebelli im pränatalen Ultraschall: Systematischer Überblick und Metaanalyse
Joshua I Rosenbloom 
1   Obstetrics and Gynecology Hadassah Medical Organization and Faculty of Medicine Hebrew University of Jerusalem Jerusalem, Israel
2   Obstetrics and Gynecology, Washington University in Saint Louis School of Medicine, Saint Louis, United States
,
Lauren H. Yaeger
3   Bernard Becker Medical Library, Washington University in Saint Louis School of Medicine, Saint Louis, United States
,
Shay Porat
1   Obstetrics and Gynecology Hadassah Medical Organization and Faculty of Medicine Hebrew University of Jerusalem Jerusalem, Israel
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Abstract

Purpose To conduct a systematic review and meta-analysis of published nomograms for fetal vermis biometry.

Materials and Methods A structured literature search was conducted to identify studies that reported normal measurements of the fetal vermis. A customized quality assessment tool was used to review the selected articles. Random effects meta-analysis was used to calculate normal ranges for vermian craniocaudal diameter, anteroposterior diameter, and surface area.

Results A total of 21 studies were included for qualitative review and 3 studies were included for quantitative synthesis. The 3 included articles comprised a total of 10 910 measurements from gestational ages 17–35 weeks. The quality assessment demonstrated that there was generally poor reporting regarding maternal characteristics and neonatal outcomes. Except for one article with a large sample size, the mean number of fetuses per week of gestational age was 15.9, with the lowest number being 5. There was significant statistical heterogeneity. Non-visualization rates ranged from 0–35.4 %. The craniocaudal diameter (reported in 3 articles) increased from a mean of 7.90 mm (95 % confidence interval [CI] 7.42, 8.38) at 17 weeks to 21.90 mm (95 % CI 20.63, 23.16) at 35 weeks gestation. The anteroposterior diameter (reported in 2 articles) increased from 6.30 mm (95 % CI 5.42, 7.18) at 17 weeks to 15.85 (95 %CI 15.49, 16.21) at 32 weeks.

Conclusion Reference ranges for vermis biometry across gestation based on meta-analysis of existing references are provided. However, because many of the underlying studies suffered from significant methodological issues, the ranges should be used with caution.

Zusammenfassung

Ziel Durchführung eines systematischen Reviews und Metaanalyse veröffentlichter Nomogramme für die Biometrie des fetalen Vermis cerebelli.

Material und Methoden Eine strukturierte Literaturrecherche wurde durchgeführt, um Studien zu identifizieren, die über normale Messungen des fetalen Vermis berichteten. Ein angepasstes Qualitätsbewertungs-Tool wurde verwendet, um die ausgewählten Artikel zu überprüfen. Eine Metaanalyse mit Random Effects wurde angewandt, um Normalbereiche für den kraniokaudalen Durchmesser des Vermis, den anteroposterioren Durchmesser und die Oberfläche zu berechnen.

Ergebnisse Insgesamt wurden 21 Studien zur qualitativen Überprüfung und 3 Studien zur quantitativen Synthese eingeschlossen. Die 3 eingeschlossenen Artikel umfassten insgesamt 10 910 Messungen von der 17.–35. SSW. Die Qualitätsbewertung zeigte, dass es im Allgemeinen eine schlechte Berichterstattung bezüglich mütterlicher Charakteristiken und des neonatalen Outcomes gab. Mit Ausnahme eines Artikels mit großer Stichprobengröße betrug die durchschnittliche Anzahl der Föten pro SSW 15,9, wobei die niedrigste Anzahl 5 betrug. Es gab eine signifikante statistische Heterogenität. Die Raten für Nichtdarstellbarkeit lagen zwischen 0 und 35,4 %. Der kraniokaudale Durchmesser (in 3 Artikeln angegeben) stieg von durchschnittlich 7,90 mm (95 %-Konfidenzintervall (KI) 7,42–8,38) in der 17. SSW auf 21,90 mm (95 %-KI 20,63–23,16) in der 35. SSW. Der anteroposteriore Durchmesser (in 2 Artikeln angegeben) stieg von 6,30 mm (95 %-KI 5,42–7,18) in der 17. SSW auf 15,85 mm (95 %-KI 15,49–16,21) in der 32. SSW.

Schlussfolgerung Basierend auf einer Metaanalyse bestehender Literatur werden Referenzbereiche für die Biometrie des Vermis nach Schwangerschaftsalter angegeben. Da jedoch viele der zugrunde liegenden Studien unter erheblichen methodischen Problemen litten, sollten diese Bereiche mit Vorsicht angewandt werden.

Key words

obstetrics - neurology - vermis

Supplement



Publication History

Received: 14 July 2020

Accepted: 15 February 2021

Article published online:
09 April 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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