Screening for trisomy 21 with ultrasonographic determination of biparietal diameter/femur length ratio

Determination of gestational age (GA) with precision is vital to the proper care of pregnant mothers. Our present study aimed at determining the gestational ages by the ultrasonic measurements of four standard fetal parameters namely biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) specifically focusing on the Bangladeshi ethnic population. The current study is cross-sectional but data were collected in a prospective nature. There were 229 Bangladeshi women who had usual singleton fetuses with the evidence of menstrual dates by sonography before 14 weeks. Fetal anatomical structures have been scanned and measured at the time of sonographic inspection. Multiple linear regression models of GA by the date of last menstrual period (LMP) and GA by ultrasonographic measures have been fitted on four fetal parameters for our analysis. In the present analysis, we have found that all the response variables i.e. gestational age by LMP and gestational age by ultrasonography (USG) clearly depend on the fetal parameters. The best subsets regression analysis shows that BPD, AC, and FL are the best predictors of GA by LMP (adj R 2 = 96.54). In terms of Mallow’s Cp and adj R 2 , it is found that all the fetal parameters BPD, AC, HC and FL are important predictors for GA by USG. It has been observed that multiple fetal parameters measured by ultrasonography can be useful to predict gestational age during second and third trimesters. Precise estimation of gestational age by this method is helpful to reduce pregnancy-related complicacy and maternal death in the developing countries including Bangladesh.

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Ultrasonographic evaluation of fetal sacral length and correlation with gestational age.

Update Dental College Journal ◽

10.3329/updcj.v6i1.29214 ◽

2016 ◽

Vol 6 (1) ◽

pp. 8-14

Author(s):

Syed Abdul Quader ◽

Md Saiful Islam ◽

Md Menhazul Islam ◽

Md Zakir Hossain

Keyword(s):

Gestational Age ◽

Sacrococcygeal Teratoma ◽

Multiple Pregnancies ◽

Femur Length ◽

Foot Length ◽

Biparietal Diameter ◽

Vertebral Arch ◽

Ultrasound Scanner ◽

Positive Significant Correlation

Background: During the last three decades, ultrasonographics of a number of fetal osseous structures have been adopted for the assessment of gestational age and the evaluation of fetal growth and development. The most frequently used morphometric parameters include biparietal diameter, head circumference and femur length. Moreover, nomograms for other osseous structures, such as mandible, clavicle, scapula, vertebral arch, iliac bone and foot length have been established. Another suggestion is to measure the length of fetal sacrum, which should be visualized as a part of routine ultrasonographic evaluation of a fetus. Hence, associated congenital anomalies such as sacral agenesis or sacrococcygeal teratoma can be detected simultaneouslyObjective: To evaluate the usefulness of fetal sacral length in determination of gestational age at 15th to 40th weeks of pregnancy.Method: This study was carried out on 441 normal pregnant women between 15 to 40 weeks of gestation over a period of 24 months to find out the correlation between gestational ages with fetal sacral length measured by ultrasonographically. 41 patients were excluded from my study as 09 had multiple pregnancies, 02 had fetal congenital anomaly; out of them one had anencephaly and one had lumbo-sacral meningocele and complete visualization of sacrum was not possible for 30 fetuses.Result: Measurements of fetal sacral length were performed by utilizing gray scale real time ultrasound scanner equipped with 3.5 MHz convex transducer and gestational age was estimated by LMP.The mean gestational age was 27.52 with standard deviation of mean (±SD) was ± 7.28 weeks and gestational age ranging from 15 to 40 weeks. 40.0% percent were Primigravida, 31.75% percent were 2ndgravida, 18.25 percent were 3rdgravida, 7.75 percent were 4th gravid and 1.75% percent were 5th and more gravida. Most of the cases were Primigravida and 2ndgravida. A positive significant correlation were found between fetal sacral length with gestational age (wk) (r=0.998; p<0.001 and R²=99%)Conclusion:In this study it is observed that there is significant correlation of fetal sacral length with estimated fetal age so, it can be concluded in the present study that fetal sacral length(FSL) can be used as a parameter for estimation of gestational age.Update Dent. Coll. j: 2016; 6 (1): 08-14

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