Journal of Clinical Ultrasound最新文献

{"title":"Role of Ultrasound in the Evaluation of Diabetics-Related Complication: A Systematic Review and Meta-Analysis.","authors":"Yifei Guo, Dawei Wang, Xingxing Sun, Yulei Wan","doi":"10.1002/jcu.70330","DOIUrl":"https://doi.org/10.1002/jcu.70330","url":null,"abstract":"<p><p>Diabetes mellitus is associated with a wide spectrum of macrovascular and microvascular complications affecting multiple organ systems. Ultrasound offers a noninvasive, accessible imaging modality for the early detection of these complications. This systematic review and meta-analysis evaluated the diagnostic role of ultrasound across diabetes-related complications, including nephropathy, neuropathy, hepatic fibrosis, carotid atherosclerosis, plantar fasciitis, and cardiac vascular alterations. Relevant studies were identified from PubMed, Scopus, and the Cochrane Library, supplemented by gray literature, and appraised using the Newcastle-Ottawa Scale. The meta-analysis was performed using Jamovi software in accordance with PRISMA guidelines. Pooled findings demonstrated that the renal resistive index (RI) measured by Doppler ultrasound was significantly elevated in diabetic nephropathy compared with controls. Plantar fascia thickness, peripheral nerve cross-sectional area, and liver stiffness were all significantly greater in diabetic patients than in non-diabetic controls (p < 0.05 across outcomes). Carotid intima-media thickness and vascular resistance parameters were also measurably increased, reflecting early atherosclerotic changes. These results confirm that ultrasound is a versatile and diagnostically valid tool across multiple diabetes-related complication domains, with particular strength in hepatic, neurological, renal, and musculoskeletal assessment. The consistent findings across organ systems support its integration into routine diabetic surveillance. Standardized acquisition protocols and larger prospective studies are needed to consolidate reference ranges and strengthen clinical applicability.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Cervical Length in Placenta Accreta Spectrum and Its Effects on Maternal and Fetal Outcomes: A Prospective Cohort Study.","authors":"Sedigheh Hantoushzadeh, Sedigheh Borna, Fahimeh Ghotbizadeh Vahdani, Zahra Panahi, Hediye Gholamshahi, Leila Sahebi, Masoumeh Masoumi, Sooreh Sheykham, Marjan Ghaemi","doi":"10.1002/jcu.70387","DOIUrl":"https://doi.org/10.1002/jcu.70387","url":null,"abstract":"<p><strong>Background: </strong>Placenta accreta spectrum (PAS) has high maternal morbidity and poor neonatal outcomes, although the best time for delivery is not clear. Cervical length (CL) may serve as a useful adjunct for risk stratification and individualized delivery planning in PAS pregnancies.</p><p><strong>Objective: </strong>To examine the association of serial cervical length measurement with delivery timing and maternal and neonatal outcomes in women with PAS.</p><p><strong>Methods: </strong>In this prospective cohort study at three university hospitals in Tehran, 41 pregnant women antenatally diagnosed with PAS had transvaginal sonographic CL measurements performed at 28, 32, and 34 weeks' gestation. The main outcome was gestational age at delivery and its connection with the CL. Maternal complications and neonatal morbidity constituted secondary outcomes.</p><p><strong>Results: </strong>Short CL (< 25 mm) at 28 and 32 weeks was significantly related to delivery at ≤ 34 weeks (p < 0.05) and increased Cesarean hysterectomy rates (p = 0.002 at 32 weeks; p = 0.005 at 34 weeks). Emergent Cesarean delivery was more common among PAS patients with CL < 25 mm at 32 and 34 weeks (p = 0.02). Neonates from mothers with short CL had increased likelihood for antibiotics, surfactant, resuscitation, and intubation (all p < 0.05). No significant relations were seen for CL and intraoperative bladder damage or estimated blood loss.</p><p><strong>Conclusions: </strong>Cervical shortening in the late second and early third trimester in PAS women is significantly associated with earlier term delivery, increased risk of Cesarean hysterectomy, and neonatal morbidity for PAS pregnancies. Repeated assessments of CL may be a useful adjunct for individualizing delivery timing and optimizing maternal-fetal outcomes. Larger prospective multicenter trials are essential to validate the role of CL in risk stratification and to integrate it into an individualized delivery planning algorithm.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Predictive Accuracy of Prenatal Ultrasound for Macrosomia-A Retrospective Cohort Study.","authors":"Isabella Abati, Mor Huri, Noemi Strambi, Laura Capiluppi, Silvia Giovinale, Viola Seravalli, Mariarosaria Di Tommaso","doi":"10.1002/jcu.70397","DOIUrl":"https://doi.org/10.1002/jcu.70397","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the accuracy of third-trimester ultrasound for fetal macrosomia and to assess obstetric outcomes associated with its prenatal suspicion.</p><p><strong>Methods: </strong>Retrospective cohort study on women receiving prenatal care at a tertiary care hospital between November 2017 and December 2022. Singleton pregnancies with prenatal suspicion of macrosomia (estimated fetal weight ≥ 4000 g or > 90th percentile for gestational age) were included. Controls were singleton term deliveries without suspected macrosomia. Cases were categorized as true positives (TP) and false positives (FP), based on birthweight. Diagnostic accuracy for neonatal macrosomia was evaluated. Obstetric outcomes were compared between cases and controls, and between the TP and FP groups.</p><p><strong>Results: </strong>A total of 365 patients received a prenatal suspicion of macrosomia during the study period, of whom 239 (65.48%) were classified as TP and 126 (34.52%) as FP. The FP rate did not differ significantly whether the ultrasound assessment was performed before or after 37 weeks. The prenatal suspicion of fetal macrosomia presented high specificity (98.49%) and negative predictive value (97.78%), but low sensitivity (63.75%) and positive predictive value (72.34%) for neonatal macrosomia. Additionally, a prenatal suspicion of macrosomia was strongly associated with labor induction (57.26% vs. 25.52% in the control group, p < 0.001), with 27.27% of inductions occurring before 39 weeks.</p><p><strong>Conclusions: </strong>Third-trimester fetal weight estimation has limited predictive accuracy for neonatal macrosomia, and sonographic suspicion of macrosomia is strongly associated with labor induction. These findings suggest that suspected prenatal macrosomia should not be used in isolation when planning obstetric management, including decisions regarding labor induction.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gestational Age-Specific Reference Ranges for Multimodal Cranial Ultrasound Parameters of Brain Parenchyma in Neonates: A Retrospective Cross-Sectional Study.","authors":"Jianming Song, Xianlian Su, Zhiqiang Chen, Han Chen, Jing Lin, Zhiwei Zhang","doi":"10.1002/jcu.70409","DOIUrl":"https://doi.org/10.1002/jcu.70409","url":null,"abstract":"<p><strong>Background: </strong>Cranial ultrasound (cUS) is the first-line neonatal neuroimaging modality; however, quantitative gestational age (GA)-specific reference ranges for multimodal brain parenchyma parameters remain undefined.</p><p><strong>Objective: </strong>To establish GA-stratified reference values for structural, hemodynamic, elastographic, volumetric, and microvascular cUS parameters in neonates without major cerebral or systemic abnormalities.</p><p><strong>Methods: </strong>This retrospective cross-sectional study enrolled 100 neonates without major cerebral or systemic abnormalities (GA 24-42 weeks) across four groups (n = 25 each). Nine parameters were assessed within 24-72 h using an Aloka Symphony 70: lateral ventricle width, grayscale echogenicity in the periventricular white matter, middle cerebral artery (MCA) peak systolic velocity (PSV), resistive index (RI), and pulsatility index (PI), periventricular white matter and basal ganglia Young's modulus, ventricle-to-parenchyma volume ratio (VV/PV), and microvascular density (MVD).</p><p><strong>Results: </strong>All nine parameters showed significant GA-dependent variation (p < 0.001). Strongest positive correlations with GA were observed for white matter stiffness (r = 0.912) and MVD (r = 0.896); strongest negative correlations for VV/PV (r = -0.790) and RI (r = -0.738). White matter stiffness increased from 2.89 to 7.96 kPa; MVD nearly tripled. Centile tables (P5-P95) were generated for all parameters.</p><p><strong>Conclusions: </strong>This study provides the first comprehensive multimodal GA-specific reference ranges for neonatal brain parenchyma, potentially facilitating early detection of maturational deviations in clinical neurosonography.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relative Contributions of Alpha and Beta Angles to Age-Specific Graf Classification in Infant Hip Ultrasonography: A Retrospective Study.","authors":"Guo Chen, Yunxi Fu, Zhennian Gou, Qingjin Wan, Yashan Wang, Yuxin Xue, Xinlu Li, Meiqi Jing, Junli Xu, Han Ning, Li Wang, Pengfei Liu, Xinyu Xu, Li Yi","doi":"10.1002/jcu.70407","DOIUrl":"https://doi.org/10.1002/jcu.70407","url":null,"abstract":"<p><strong>Background: </strong>Because the age-specific Graf endpoint is itself defined by the alpha and beta angles, angle-based discrimination is inherently classification-internal rather than a measure of independent diagnostic accuracy. Within this framework, the relative contribution of alpha and beta angles to the classification was quantified.</p><p><strong>Methods: </strong>This single-center retrospective study included 313 infants examined from May 2025 to May 2026. The endpoint was Graf IIa or higher in infants younger than 3 months and Graf IIb or higher in infants aged 3 months or older. Logistic regression, receiver operating characteristic analysis, paired DeLong tests, bootstrap validation, side-level generalized estimating equations, an age interaction analysis, and bootstrap estimation of calibration slope and intercept were used.</p><p><strong>Results: </strong>The endpoint was positive in 140 infants (44.7%). Worst alpha angle had an area under the curve of 0.904 (95% confidence interval, 0.867-0.940), versus 0.666 (95% confidence interval, 0.606-0.726) for worst beta angle and 0.903 for the multivariable model. Each 1° increase in worst alpha angle was associated with lower odds of endpoint positivity (odds ratio, 0.495; 95% confidence interval, 0.417-0.574; p < 0.001). Worst beta angle and sex were not independently associated. In a post hoc age interaction analysis, adding an age-by-worst-alpha term improved model fit (likelihood ratio test p = 0.026; Akaike information criterion 261.7-248.7), with an interaction odds ratio of 1.132 (95% confidence interval, 1.015-1.270; p = 0.030). Bootstrap calibration of the primary model showed an optimism-corrected slope of 0.976 (95% confidence interval, 0.706-1.251) and intercept of 0.009 (95% confidence interval, -0.274 to 0.326).</p><p><strong>Conclusion: </strong>Within the age-specific Graf framework, the worst alpha angle captured most of the classification-internal statistical information, whereas beta angle and sex added little discrimination, and model calibration was adequate. Because the endpoint is defined by the angles themselves, these findings describe the internal structure of the classification and do not establish diagnostic accuracy against an independent reference standard or justify omitting beta angle from a complete clinical Graf examination.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transperineal Ultrasound in Chronic Pelvic Pain: A Systematic Review.","authors":"Giulia Paoni Saccone, Noemi Tonti, Valeria Gangale, Maria Grazia Porpora, Federica Tomao, Violante Di Donato, Innocenza Palaia, Giusi Santangelo, Ludovico Muzii, Giuseppe Rizzo, Giorgia Perniola","doi":"10.1002/jcu.70406","DOIUrl":"10.1002/jcu.70406","url":null,"abstract":"<p><p>This systematic review aimed to explore the application and effectiveness of transperineal ultrasound as a diagnostic tool for evaluating pelvic floor musculature (PFM) dysfunction in patients with chronic pelvic pain and related conditions, including endometriosis, vulvodynia, and gynecological cancers. Comprehensive searches were conducted across five databases, resulting in the identification of 395 articles, of which 17 were included after screening. Studies reported significant PFM alterations, including a reduced levator hiatal area and decreased excursion of the levator plate angle and anorectal angle, indicating increased PFM tone and diminished contractile capacity. Transperineal ultrasound has shown substantial reliability in assessing PFM disorders.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Depth of Invasion in Tongue Carcinoma: Correlation of Intraoral Ultrasound and Magnetic Resonance Imaging and With Histopathological Findings.","authors":"Anamika Das, Jyoti Kumar, Swezal Lohia, Anjali Prakash, Meeta Singh, Ravi Meher","doi":"10.1002/jcu.70402","DOIUrl":"https://doi.org/10.1002/jcu.70402","url":null,"abstract":"<p><strong>Background: </strong>Tongue carcinoma requires accurate preoperative assessment of depth of invasion (DOI) for optimal management and prognostication. The 8th AJCC/UICC TNM staging system recognizes DOI as a key determinant of T-stage, risk of nodal metastases, and survival. Magnetic Resonance imaging (MRI) offers excellent soft-tissue contrast, whereas intraoral ultrasound (IOUS) provides a rapid, high-resolution, and cost-effective alternative. This study correlates DOI measured on IOUS and MRI with histopathological DOI and evaluates their association with cervical nodal metastasis in early tongue carcinoma.</p><p><strong>Methods: </strong>This prospective cross-sectional study was conducted over 2 years and included 30 adult patients with histopathologically confirmed tongue carcinoma planned for surgical resection. IOUS was performed with an hockey-stick probe on GE LOGIQ machine and MRI was acquired on a 3 T system using T1W, T2W, and post-contrast 3D VIBE sequences. Post-surgical specimens and neck nodes were sent for histopathological assessment.</p><p><strong>Results: </strong>Both IOUS and MRI showed strong correlation with histopathological DOI (p < 0.01), with IOUS demonstrating slightly higher accuracy (Spearman's ρ = 0.89) than MRI (ρ = 0.86). MRI showed excellent interobserver agreement (ρ = 0.97). T-staging on imaging closely matched histopathology. Bland-Altman analysis showed a mean difference of 0.7 mm (95% LOA: -4.2 to 5.7 mm) for IOUS-DOI relative to histopathological DOI, whereas MRI exhibited a mean difference of 0.2 mm (95% LOA: -5.4 to 5.9 mm). Cervical lymph node metastasis occurred in 8 patients and correlated significantly with higher T-stage (p = 0.029). A DOI > 10 mm predicted increased risk of nodal metastasis.</p><p><strong>Conclusions: </strong>IOUS and MRI are reliable modalities for preoperative DOI assessment in tongue carcinoma, with IOUS offering marginally superior accuracy in early tongue carcinoma. DOI strongly correlates with nodal metastasis, highlighting its prognostic and surgical importance.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Torcular Herophili Thrombosis Initially Suspected to Represent an Arachnoid Cyst: A Prenatal Case Report.","authors":"Ahmet Kurt, Dilara Sarikaya Kurt, Murat Levent Dereli","doi":"10.1002/jcu.70405","DOIUrl":"https://doi.org/10.1002/jcu.70405","url":null,"abstract":"<p><p>Torcular Herophili thrombosis is a rare fetal dural venous condition with a heterogeneous course, ranging from spontaneous regression to parenchymal injury, neurological impairment, or perinatal death. Prenatal ultrasound is generally the first-line imaging modality, whereas fetal magnetic resonance imaging (MRI) provides complementary information regarding lesion origin and associated intracranial abnormalities. After diagnosis, serial ultrasonographic follow-up is recommended to monitor lesion evolution and fetal well-being. We report a fetus referred at 23 weeks' gestation with a presumed arachnoid cyst. Serial prenatal ultrasonography demonstrated antenatal regression, and postnatal ultrasonography, brain MRI, and MRV confirmed complete resolution with normal patency of the major dural venous sinuses. This case illustrates a recognized diagnostic pitfall in the evaluation of midline posterior intracranial cystic-appearing lesions and highlights the complementary roles of Doppler ultrasound, fetal MRI, and postnatal venous follow-up.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrauterine Pregnancy Combined With Ovarian Pregnancy Was Missed by Ultrasound: A Case Report.","authors":"Xiao-Zheng Zhang, Xiao-Zhuo Wang, Shuang Zheng, Yu-Qiong Zhou, Dong-Ping Zheng","doi":"10.1002/jcu.70365","DOIUrl":"https://doi.org/10.1002/jcu.70365","url":null,"abstract":"<p><p>A 32-year-old G2P0 female presented with 4+ weeks of amenorrhea and acute-onset lower abdominal pain with vaginal bleeding. Initial ultrasound confirmed a 6+ week intrauterine pregnancy. The patient underwent painless uterine curettage on the third day because the patient voluntarily chose to terminate the pregnancy. Five days postoperatively, she developed severe pain and hemorrhage. Repeat imaging revealed an 11.26 × 5.73 cm heterogeneous left ovarian mass with a gestational sac-like structure and vascular flow, along with 1500 mL of hemoperitoneum. Pathology confirmed an ovarian pregnancy. She underwent laparoscopic left ovarian lesion resection and ovarian plasty.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Maternal Serum PAPP-A (< 0.3 MoM) at First Trimester Screening and Fetal Malformations in Euploid Fetuses.","authors":"Mariachiara Bosco, Ilaria Fantasia, Tiziana Fanelli, Angela Gentile, Claudiana Olivieri, Mauro De Guglielmo, Paolo Volpe","doi":"10.1002/jcu.70357","DOIUrl":"https://doi.org/10.1002/jcu.70357","url":null,"abstract":"<p><strong>Introduction: </strong>Low values of first trimester maternal serum PAPP-A have demonstrated to correlate with an increased risk of fetal aneuploidies and adverse obstetrics outcomes such as preeclampsia and low birth weight. However, the role of a low first trimester PAPP-A in the identification of fetuses at risk of nonchromosomal malformations has not been clarified. This study aimed to investigate the association between low PAPP-A values (< 0.3MoM) at first trimester screening and the diagnosis of fetal malformations during pregnancy in euploid fetuses.</p><p><strong>Methods: </strong>A retrospective study of women who underwent first trimester screening between 2010 and 2020 to identify all cases with a low PAPP-A (< 0.3 MoM) and normal genetic results after invasive procedure for fetal karyotype and array CGH. Controls were women with a PAPP-A ≥ 0.3 MoM and at low risk for aneuploidies at first trimester screening. We excluded women with multiple gestation and with intrauterine fetal demise. The main outcome was the antenatal diagnosis of fetal malformation during follow-up.</p><p><strong>Results: </strong>We included in the final analysis 180 women with PAPP-A < 0.3 and a normal genetic testing and 104 women with PAPP-A ≥ 0.3 MoM and low risk for aneuploidies at first trimester screening (controls). A fetal malformation was identified in 11.1% (20/180) of women with a low PAPP-A compared to 2.9% (3/104) of women with PAPP-A ≥ 0.3 MoM (p < 0.001). PAPP-A < 0.3 MoM was the only factor independently associated with a diagnosis of fetal malformation at univariable (OR 4.21, 95% CI 1.22-14.53; p = 0.02) and in the final multivariable logistic regression model (OR 3.7, 95% CI 1.01-13.52; p = 0.047).</p><p><strong>Conclusions: </strong>Low first trimester PAPP-A is independently associated with fetal malformations in the euploid population. This protein might represent a marker for early identification of patients who might benefit from appropriate prenatal counseling and referral to an expert center for thorough first trimester anatomical evaluation and ultrasound serial follow-up.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}