ORIGINAL RESEARCH article
Front. Med.
Sec. Obstetrics and Gynecology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1637954
First-trimester choroid plexus-to-head ratio: a novel sonographic marker for early detection 2 of fetal central nervous system malformations
Provisionally accepted
- Chongqing Health Center for Women and Children, Chongqing, China
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ABSTRACT 23 Background 24 Prenatal diagnosis of nervous system malformations associated with abnormal development of 25 cerebrospinal fluid is most commonly made in the mid-trimester. During early gestation, the 26 choroid plexus is the dominant structure occupying the lateral ventricles. Detection of 27 abnormally positioned choroid plexuses within the fetal head may serve as a novel sonographic 28 marker for the early identification of these malformations. 29 Methods: 30 This was a retrospective study of singleton pregnancies with nervous system abnormalities. In the 31 first trimester, the choroid plexus area (CPA), choroid plexus length (CPL), occipitofrontal 32 diameter (OFD), head area (HA), head circumference (HC), abdominal circumference (AC) and 33 the distance between the anterior margin of the choroid plexus (CP) and lateral border of the 34 frontal bone (CFD) were measured in the transventricular axial plane. The ratios of CPA/HA, 35 CPL/OFD, CFD/OFD and HC/AC were also assessed. 36 Results: 37 A total of 256 fetuses were included in the control group, and a reference range was established. 38 Finally, 52 cases with nervous system abnormalities associated with abnormal cerebrospinal fluid 39 development were confirmed . In the control group, the ratios of CPA/HA and CPL/OFD 40 decreased (r = -0.499, -0.216 respectively, both P < 0.001), whereas the CFD/OFD ratio increased 41 (r = 0.445, P < 0.001). Compared with control group, scatter diagrams and box-and-whiskers plots 42 represented ventriculomegaly (VM) fetuses had significantly decreased in CPA/HA and CPL/OFD 43 ratios (P < 0.001), but increased CFD/OFD and HC/AC ratios (P < 0.001). Both CPA/HA, 44 CPL/OFD and CFD/OFD ratio were significantly higher in fetuses with open spina bifida (OSB) 45 (P < 0.05). Fetuses with microcephaly showed a significant higher CPA/HA ratio (P < 0.001), 46 higher CPL/OFD ratio (P < 0.001) and lower HC/AC ratio (P < 0.05). 47 Conclusion: 48 Choroid-plexus-to-head ratios offer an objective means of assessing nervous system 49 malformations associated with abnormal cerebrospinal fluid development during the first 50 trimester. 51 Trial registration: retrospectively registered.
Keywords: Prenatal Diagnosis, Choroid Plexus, Head, Nervous System Malformations, First trimester
Received: 30 May 2025; Accepted: 09 Oct 2025.
Copyright: © 2025 Xue, Tu, Zhang, Ran and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xuemei Zhang, swinters789@163.com
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