First‐Trimester Abdominal Circumference (Versus Crown Rump Length) Improves Precision in Inter‐ and Intraobserver Variability

2018 ◽  
Vol 38 (8) ◽  
pp. 2161-2167 ◽  
Author(s):  
Yalda Afshar ◽  
Rachel Gutkin ◽  
Deborah Krakow ◽  
Howard Cuckle ◽  
Neil S. Silverman ◽  
...  
Keyword(s):  
First Trimester ◽  
Abdominal Circumference ◽  
Intraobserver Variability ◽  
Crown Rump Length

scholarly journals The Association of Maternal Age With Fetal Growth and Newborn Measures: The Mumbai Maternal Nutrition Project (MMNP)

2018 ◽  
Vol 26 (7) ◽  
pp. 918-927 ◽  
Author(s):  
Chiara Di Gravio ◽  
Ashwin Lawande ◽  
Ramesh D. Potdar ◽  
Sirazul A. Sahariah ◽  
Meera Gandhi ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Maternal Age ◽  
Maternal Nutrition ◽  
First Trimester ◽  
Abdominal Circumference ◽  
Crown Rump Length ◽  
Fetal Biometry ◽  
Biparietal Diameter ◽  
Using Data ◽  
Newborn Size

Background: Young maternal age is associated with poorer birth outcomes, but the mechanisms are incompletely understood. Using data from a prospective cohort of pregnant women living in Mumbai slums, India, we tested whether lower maternal age was associated with adverse fetal growth. Methods: Fetal crown-rump length (CRL) was recorded at a median (interquartile range, IQR) of 10 weeks’ gestation (9-10 weeks). Head circumference (HC), biparietal diameter (BPD), femur length (FL), and abdominal circumference (AC) were recorded at 19 (19-20) and 29 (28-30) weeks. Newborns were measured at a median (IQR) of 2 days (1-3 days) from delivery. Gestation was assessed using prospectively collected menstrual period dates. Results: The sample comprised 1653 singleton fetuses without major congenital abnormalities, of whom 1360 had newborn measurements. Fetuses of younger mothers had smaller CRL (0.01 standard deviation [SD] per year of maternal age; 95% confidence interval CI: 0.00-0.02 1 ; P = .04), and smaller HC, FL, and AC at subsequent visits. Fetal growth of HC (0.04 cm; 95% CI: 0.02-0.05; P < .001), BPD (0.01 cm; 95% CI: 0.00-0.01; P = .009), FL (0.04 cm; 95% CI: 0.02-0.06; P < .001), and AC (0.01 cm; 95% CI: 0.00-0.01; P = .003) up to the third trimester increased with maternal age. Skinfolds, head, and mid-upper arm circumferences were smaller in newborns of younger mothers. Adjusting for maternal prepregnancy socioeconomic status, body mass index, height, and parity attenuated the associations between maternal age and newborn size but did not change those with fetal biometry. Conclusion: Fetuses of younger mothers were smaller from the first trimester onward and grew slower, independently of known confounding factors.

scholarly journals Sex differences in fetal growth and immediate birth outcomes in a low-risk Caucasian population

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Sander Galjaard ◽  
Lieveke Ameye ◽  
Christoph C. Lees ◽  
Anne Pexsters ◽  
Tom Bourne ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Fetal Growth ◽  
Head Circumference ◽  
Growth Curves ◽  
First Trimester ◽  
Low Risk ◽  
Abdominal Circumference ◽  
Fetal Ultrasound ◽  
Crown Rump Length ◽  
Gender Specific

Abstract Background According to the WHO Multicentre Growth Reference Study Group recommendations, boys and girls have different growth trajectories after birth. Our aim was to develop gender-specific fetal growth curves in a low-risk population and to compare immediate birth outcomes. Methods First, second, and third trimester fetal ultrasound examinations were conducted between 2002 and 2012. The data was selected using the following criteria: routine examinations in uncomplicated singleton pregnancies, Caucasian ethnicity, and confirmation of gestational age by a crown-rump length (CRL) measurement in the first trimester. Generalized Additive Model for Location, Scale and Shape (GAMLSS) was used to align the time frames of the longitudinal fetal measurements, corresponding with the methods of the postnatal growth curves of the WHO MGRS Group. Results A total of 27,680 complete scans were selected from the astraia© ultrasound database representing 12,368 pregnancies. Gender-specific fetal growth curves for biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) were derived. The HC and BPD were significantly larger in boys compared to girls from 20 weeks of gestation onwards (p < 0.001) equating to a 3-day difference at 20–24 weeks. Boys were significantly heavier, longer, and had greater head circumference than girls (p < 0.001) at birth. The Apgar score at 1 min (p = 0.01) and arterial cord pH (p < 0.001) were lower in boys. Conclusions These longitudinal fetal growth curves for the first time allow integration with neonatal and pediatric WHO gender-specific growth curves. Boys exceed head growth halfway of the pregnancy, and immediate birth outcomes are worse in boys than girls. Gender difference in intrauterine growth is sufficiently distinct to have a clinically important effect on fetal weight estimation but also on the second trimester dating. Therefore, these differences might already play a role in early fetal or immediate neonatal management.

Crown–rump length measurement: a new age for first‐trimester ultrasound?

2021 ◽  
Author(s):  
J. Stirnemann ◽  
M. Massoud ◽  
N. Fries ◽  
C. Dumont ◽  
G. Haddad ◽  
...  
Keyword(s):  
First Trimester ◽  
New Age ◽  
Length Measurement ◽  
Crown Rump Length ◽  
First Trimester Ultrasound

scholarly journals Frontomaxillary Facial Angle Measurement in Screening for Trisomy 18 at 11 + 0 to 13 + 6 Weeks of Pregnancy: A Double-Centre Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Bartosz Czuba ◽  
Wojciech Cnota ◽  
Agata Wloch ◽  
Piotr Wegrzyn ◽  
Krzysztof Sodowski ◽  
...  
Keyword(s):  
Final Analysis ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Angle Measurement ◽  
Trisomy 18 ◽  
Crown Rump Length ◽  
Beta Hcg ◽  
Large Populations ◽  
Trimester Screening ◽  
Independent Marker

Objective. The aim of this study was to evaluate the effectiveness of prenatal screening for trisomy 18 with the use of the frontomaxillary facial angle (FMF angle) measurement.Material and Methods. The study involved 1751 singleton pregnancies at 11–13 + 6 weeks, examined between 2007 and 2011. Serum PAPP-A and free beta-hCG levels were assessed, and crown-rump length, nuchal translucency, and FMF angle were measured in all patients. 1350 fetuses with known follow-up were included in the final analysis.Results. Highly significant (P<0.01) negative correlation between the CRL and the FMF angle was found. There were 30 fetuses with trisomy 18. FMF angle was highly significantly larger (P<0.0001) in fetuses with trisomy 18 as compared to chromosomally normal fetuses. Two models of first trimester screening were compared: Model 1 based on maternal age, NT, and first trimester biochemistry test (DR 80–85% and FPR 0.3–0.6%), and Model 2 = Model 1 + FMF angle measurement (DR 87.3–93.3% and FPR 0.8–1.3%).Conclusions. The use of FMF angle measurement increases the effectiveness of the screening for trisomy 18. Introduction of the FMF angle as an independent marker for fetal trisomy 18 risk requires further prospective research in large populations.

First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies

2015 ◽  
Vol 43 (6) ◽  
Author(s):  
Tanya Maric ◽  
Natasha Singh ◽  
Keith Duncan ◽  
Guy J. Thorpe-Beeston ◽  
Makrina D. Savvidou
Keyword(s):  
Fetal Growth ◽  
Case Control Study ◽  
Subsequent Development ◽  
First Trimester ◽  
Case Control ◽  
Retrospective Case ◽  
Crown Rump Length ◽  
Significant Difference ◽  
Twin Pregnancies ◽  
Control Study

AbstractTo investigate the relation between first-trimester fetal growth discrepancy, as assessed by crown-rump length (CRL) at 11+0 to 13+6 weeks of gestation, and subsequent development of preeclampsia (PE) in dichorionic diamniotic (DCDA) twin pregnancies. The association between inter-twin CRL and birth weight (BW) discrepancy was also investigated.This was a retrospective, case-control study of DCDA twin pregnancies. Inter-twin CRL discrepancy was calculated as 100×(larger CRL–smaller CRL)/larger CRL. BW discordance was calculated as 100×(larger BW–smaller BW)/larger BW.The study included 299 DCDA pregnancies that remained normotensive and 35 that subsequently developed PE. There was no significant difference in the inter-twin CRL discrepancy between pregnancies complicated by PE and those that were not [3.2%, interquartile range (IQR): 0.5–4.5% vs. 3.3%, IQR: 1.4–5.5%; P=0.17]. There was a positive correlation between inter-twin CRL and BW discrepancy but only in pregnancies that remained normotensive (P<0.001). In women that subsequently developed PE, there was no association between inter-twin CRL and BW discordance (P=0.54).In unselected DCDA twins, first-trimester CRL discrepancy is not different between pregnancies that subsequently develop PE and those that remain normotensive. Furthermore, in pregnancies that are complicated by PE, the association between inter-twin CRL and BW discrepancy appears to be lost.

Three-dimensional ultrasound first trimester fetal volume measurement and its relation to pregnancy outcome

2017 ◽  
Vol 45 (9) ◽  
Author(s):  
Haitham A. Torky ◽  
Asem A. Moussa ◽  
Ali M. Ahmad ◽  
Osama Dief ◽  
Manar A. Eldesoouky ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
Gestational Age ◽  
Preterm Labor ◽  
Three Dimensional ◽  
First Trimester ◽  
3D Ultrasound ◽  
Secondary Outcome ◽  
Crown Rump Length

AbstractAim of work:To determine whether fetal volume (FV) measured by three-dimensional (3D) ultrasound was able to detect fetuses at risk of low birth weight (primary outcome) and/or preterm labor (secondary outcome).Methods:One hundred pregnant women carrying a singleton living pregnancy who were sure of dates, and had a dating scan, with gestational age between 11 weeks and 13 weeks+6 days coming for routine first trimester nuchal translucency (NT) were examined by both two-dimensional (2D) and 3D ultrasound (Vocal System) for crown-rump length (CRL) and FV then followed up regularly every 4 weeks until 28 weeks then biweekly until 36 weeks then weekly until delivery both clinically and by ultrasound biometry.Findings:Eighty-seven cases had a normal outcome, while the remaining 13 cases had either preterm labor (four cases) or low-birth weight (nine cases). FV positively correlated with CRL (P=0.026), gestational age in weeks (P=0.002), neonatal body weight in grams (P=0.018) and neonatal body length at birth (P=0.04). A mean FV of 8.3 mmConclusion:3D assessment of FV in the first trimester provides an accurate method for predicting pregnancy outcome namely low birth weight and neonatal complications, however, it is a better positive predictor than a negative one.

scholarly journals Ultrasound Assessment of Twin Reversed Arterial Perfusion Sequence for the Prediction of Adverse Pregnancy Outcomes in the First Trimester

2021 ◽  
Author(s):  
Ying Tang ◽  
Yan Zeng ◽  
Taizhu Yang ◽  
Pan Yang ◽  
Shan Bao ◽  
...  
Keyword(s):  
Gestational Age ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
University Hospital ◽  
Intrauterine Death ◽  
Crown Rump Length ◽  
Arterial Perfusion ◽  
Adverse Pregnancy ◽  
Twin Reversed Arterial Perfusion

Abstract ObjectivesTo investigate twin reversed arterial perfusion (TRAP) sequence for the prediction of TRAP-related adverse pregnancy outcomes at the gestational age of 11-14 weeks. MethodsPregnant women in the first trimester diagnosed with TRAP were recruited at West China Second University Hospital from January 2015 to June 2018. Systematic screening for the pump twin’s crown-rump length (CRL) and acardiac twin’s upper pole-rump length (URL) was conducted using ultrasonic detection. The (CRL-URL)/CRL and URL/CRL ratios were used to assess the pregnancy outcomes for the pump twin. ResultsTwenty-one pregnant women aged 21–39 years with a gestation of 11-14 weeks were recruited. TRAP was diagnosed on average (± standard deviation [SD]) at pregnancy week 13.1 ± 0.18. The pump twins’ mean (± SD) CRL was 6.65 ± 1.1 cm. The incidence of intrauterine death for the pump twins was 19.0% (n=4), the miscarriage rate was 14.3% (n=3), and the live birth rate was 66.7% (n=14). The (CRL-URL)/CRL ratios between the non-survival (intrauterine death and miscarriage) and survival groups significantly differed (0.33 ± 0.08 vs. 0.58 ± 0.08, p < 0.05). Similarly, the URL/CRL ratios between the non-survival and survival groups significantly differed (0.67 ± 0.08 vs. 0.42 ± 0.08, p < 0.05). ConclusionsThe (CRL-URL)/CRL and URL/CRL ratios were valuable indicators for determining pregnancy outcomes of pump twins with TRAP at an early gestational age.

scholarly journals The possibility of modifications methods of determine volume of amniotic fluid

2016 ◽  
Vol 65 (3) ◽  
pp. 12-17
Author(s):  
Viktor A Mudrov
Keyword(s):  
Body Mass Index ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Body Mass ◽  
Gestational Age ◽  
First Trimester ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Pregnancy And Childbirth ◽  
Maternity Hospitals

Selection of the optimal tactics of pregnancy and childbirth significantly depends on the expected volume of amniotic fluid. The amount of amniotic fluid reflects a condition of a fetus and changes at pathological conditions of both a fetus, and an uteroplacental complex. The aim of the study was a modification of methods for determining the expected volume of amniotic fluid. On the basis of maternity hospitals Trans-Baikal Region in the years 2013-2015 was held retrospective and prospective analysis of 300 labor histories, which were divided into 3 equal groups: 1 group - pregnant women with a body mass index (BMI) for Quetelet less than 24, Group 2 - with a BMI from 24 to 30, group 3 - with a BMI more than 30. In order to determine the expected volume of amniotic fluid were used the subjective method, the Chamberlain’s and Phelan’s methods. The error in determining volume of amniotic fluid by the existing methods exceeds 10 %, that defined need of creation of a quantitative method. On the basis of mathematical and 3d-modeling of the volume of amniotic fluid and fetal weight determined pattern change, which is expressed by the formula: VAF = IAF × М × π / GA2, where IAF - index of amniotic fluid (mm), M - fetal weight (g), GA - gestational age (weeks). Through a comprehensive analysis of anthropometric research of the pregnant women defined formula’s volume of amniotic fluid: V = 0,017 × HUF × (AC - 25 × BMI / GA)2 - М, where GA - gestational age (weeks), AC - abdominal circumference of the pregnant women (cm), BMI - body mass index for Quetelet in the first trimester of pregnancy (kg/m2), HUF - height of an uterine fundus (cm), M - the estimated fetal weight (g). In calculating volume of amniotic fluid according to the proposed ultrasonic formula error does not exceed 5,3 %, anthropometric formula error does not exceed 10,2 %. Thus, the method has a smaller error compared to the standard, and can be used to reliably determine volume of amniotic fluid in II and III trimester of pregnancy.

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