scholarly journals Determination of gestational age by fetal kidney length during 28-36 weeks of pregnancy by ultrasonography

2017 ◽  
Vol 06 (02) ◽  
pp. 162-167
Author(s):  
Shruthi BN ◽  
Vinay BS ◽  
◽  

Abstract Background: Accurate Gestational Age [GA] assessment is of great importance for sonologists and obstetricians in evaluations of fetal development and assessment of intrauterine growth. Aims: To establish a correlation between Fetal Kidney Length [FKL] with GA during 28-36weeks of pregnancy through ultrasonography and Comparing the accuracy of gestational age derived from mean FKL with other biometric parameters like bi-parietal diameter, head circumference, femur length and abdominal circumference and by the Last Menstrual Period [LMP]. Materials & methods: Sixty singleton uncomplicated pregnant women of different parity underwent standard ultrasound examination for foetal biometry like Bi-Parietal Diameter [BPD], Head Circumference [HC], Abdominal Circumference [AC], Femur Length [FL] and kidney length [bipolar] measurement in sagittal plane. The maximum kidney length was taken from upper pole to lower pole of any one foetal kidney in sagittal plane which was compared with GA obtained by LMP. The measurements obtained were statistically analysed by interclass correlation coefficient by using IBM- SPSS trial version 21.0 software. Results: There was a statistically significant positive correlation between the GA estimated by clinical method [LMP] and FKL. The interclass correlation coefficient was 0.79 with a 95% confidence interval of 0.67 to 0.87 [p<0.001]. FKL could predict GA with an accuracy of± 2.19 wks [95% Cl 2.03 to 2.35 wks]. Conclusion: This proves that kidney length can be used as an additional parameter to confirm the GA and also essential in detection of intrauterine kidney development and in the evaluation of fetal growth.

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Joshi BR ◽  
◽  
Chaurasia AK ◽  
Khanal UP ◽  
◽  
...  

Introduction: Various organs are measured to estimate the gestational age of fetus. Sonographically derived parameters used to date pregnancy include Crown rump length, Biparietal diameter, Head circumference, Femoral length and Abdominal circumference. Fetal kidney length, transcerebellar diameter and placental thickness are emerging as new parameters and are claiming to be more accurate in certain situations. In Nepalese context fetal kidney length has not been studied yet so this study was done to fill this need. Methodology: Obstetric sonography was performed in 108 pregnant women with uncomplicated pregnancy to evaluate the efficacy of FKL as a measure to calculate the predicted gestational age. Gestational age ranged from 20 weeks to term. Only patient with known LMP, previous history of normal menstrual cycle and without any exclusion criteria were included in the study. Results: The study showed mean fetal kidney length at 20-24, 25-29, 30- 34 and 35-37 weeks gestation as 22.5±0.5, 26.9±0.7, 32.32±0.7 and 36.3±0.6 respectively. Overall in combined second and third trimester , fetal kidney length showed strong linear correlation with gestation age with highest significant Pearson correlation coefficient of 0.989 as compared to other parameters (BPD=0.986, HC=0.976, AC=0.971, FL=0.984). Conclusion: Fetal kidney showed strongest linear correlation with clinical gestational age and it also demonstrated positive correlation with biparietal diameter, head circumference, abdominal circumference and femur length. Therefore fetal kidney length can be used as a reliable parameter for determination of gestational age.


2020 ◽  
Vol 3 (4) ◽  
pp. 01-09
Author(s):  
Amal S. Zaghloul

Accurate estimation of gestational age is necessary to obtain materials for different tests as well as to interpret the results of these tests.Unfortunately sometimes calculation of EDD based on LMP becomes very difficult when (a) The menstrual cycle is irregular; (b) Patient fails to remember LMP or reports inaccurately (c) Pregnancy occurs during lactational amenorrhoea & (d) if patient have bleeding in early pregnancy. After 24 weeks the symphysio-fundal height in cm. approximates to the number of weeks up to 36 weeks of gestation. But a number of factors influence the measurement including multiple gestation, IUGR, diabetic pregnancy, maternal size, variation in fetal lie & engagement as well as inter & intra observer measurement variation.Ultrasonic measurement of fetal biometry (CRL, BPD, FL) are considered to be reliable when they are performed in first & early 2nd trimester (<24 weeks). In this study, we aimed to evaluate the accuracy of ultrasonographic fetal kidney length measurement as a new parameter for estimation of gestational age in late second and third trimester in correlation to other commenly used parameters as, BPD, FL, AC. This study was conducted on 122 pregnant women attending antenatal care clinics of Obstetrics and Gynecology department Soliman Fakeeh Hospital, KSA. All were in the late second and third trimester (between 24-40 weeks) of gestation. Cases included in the study were divided into four gestational age groups with four weeks interval. The length of the fetal kidney was measured. The mean gestational age was calculated on the bases of biparietal diameter (BPD).femur length (FL) and abdominal circumference (AC). The fetal kidney measurements were obtained by the same sonographer to avoid interobserver variation using (GE machine E8) and were compared with gestational age using statistical analysis No statistically significant differences were found between the right and the left renal measurements in cases in which the two kidneys were imaged In this study, during the second and third trimester the mean kidney length showed gradual rate of increase. the mean kidney length was found to be 30.52.1 mm at mean gestational age of 26weeks and became at the mean gestational age of34 weeks, 40.4103 mm(:(±1.98) and at mean gestational age of 38 week it measured44.41mm((±2.1). In addition, we found a positive correlation between kidney length and gestational age. We suggested regression Formula to calculate it. Conclusion: Throughout this study, we can conclude that Fetal kidney length could be used with accuracy in the late second and third trimester especially in women who are uncertain of date of LMP and are booked late for ANC.however its accuracy is decreased when we use it in late third trimester.Other ultrasonographic parameters used for estimation of the gestational age as BPD ,AC are less satisfactory ,when compared with femur length and kidney length.


Author(s):  
Monalisa Peter ◽  
Ajit Kumar Nayak ◽  
Prajna Paramita Giri ◽  
Manju Kumari Jain

Background: Accurate assessment of gestational age is pivotal to give quality maternity care. Ultrasonographic fetal biometry is the most widespread method used to establish GA. Sonographic biometric parameters commonly used are Crown rump Length (CRL), Biparietal diameter (BPD), Head circumference (HC), Abdominal circumference (AC) and Femur length (FL). Fetal Kidney Length (FKL) is one of nontraditional parameter and more accurate method of GA estimation than BPD, FL, HC and AC after 24th week of gestation. This study evaluates role of FKL in estimation of GA and compared its accuracy with other established biometric indices.  Methods: Present study is a cross sectional study and includes healthy women who were certain of their LMP with prior regular menstrual cycles with uncomplicated pregnancy between 20 weeks of gestation to term. Maximum length of anyone single fetal kidney is measured from upper pole to lower pole at least thrice and mean of the measurements was taken. The data has been analyzed in SPSS-21 version and Microsoft word, excel have been used to generate graphs, tables etc.Results: Linear regression equation showed kidney length could predict gestational age with an accuracy ±9.048 days and predictability when combined with other biometric indices was ±8.299 days.Conclusions: The study shows good correlation between gestational age derived from FKL and gestational age from established biometric indices like BPD, HC, AC, and FL.FKL can be combined with the other four biometric indices to give a fair estimation of gestational age.


2017 ◽  
Vol 33 (3) ◽  
pp. 174-181 ◽  
Author(s):  
Charles Ugwoke Eze ◽  
Queendaline Ebere Onwuzu ◽  
Innocent Uchechukwu Nwadike

This study aimed to establish reference values of fetal transverse cerebellar diameter (TCD) in a Nigerian population. A cross-sectional convenience study was carried out between June 2013 and May 2014 in Enugu, Nigeria. The sonographic examinations were performed on 697 pregnant women with gestational ages between 14 and 40 weeks. The TCD measurements were obtained from the proximal outer margin to the distal outer margin of cerebellum. The women’s last menstrual period, femur length, biparietal diameter, head circumference, and abdominal circumference were also recorded. The mean (standard deviation) TCD increased from 13.6 (2.2) mm to 27.3 (2.6) mm and 28.9 (2.0) mm to 42.9 (2.0) mm in the second and third trimesters, respectively. The relationship of TCD with gestational age obtained from last menstrual period, femur length, biparietal diameter, head circumference, and abdominal circumference was determined. The TCD had a strong correlation with gestational age ( r = .93; P < .05). Reference values for TCD were established for those patients who attended this clinic. This is a likely data set to use for future research that could focus on similar practices and in other regions of the country for possible generation of a nationwide nomogram.


Author(s):  
Pardeshi Yogeshwari Gangadhar ◽  
Nancy S. Pillai

Background: An active approach to the diagnosis of IUGR should be undertaken so that the foetus can be closely monitored and when indicated, be promptly delivered.Methods: Study was conducted at Department of Obstetrics and Gynaecology, Pushpagiri Institute of Medical Sciences, Thiruvalla. All pregnant women whose gestational ages were assessed by ultrasonography in 1st trimester was included in the study. An ultrasonographic biometric evaluation was done between 22-24 weeks and repeated at 32-34 weeks of gestational age and their ratios compared, using standard formulae.Results: We has observed that at 22-24 weeks of gestational age abdominal circumference (AC) has a better sensitivity, specificity, NPV and PPV when compared with femur length (FL), head circumference (HC), FL/AC and HC/AC. AC has got lowest FP and FN with a highest accuracy rate of 83% as compared to FL, HC, FL/AC and HC/AC at 22-24 weeks of gestational age. At 32-34 weeks of gestational age AC remains better in sensitivity, specificity, NPV, PPV, FP and FN values as compared to FL, HC, FL/AC and HC/AC.Conclusions: AC has a better sensitivity, specificity, NPV and PPV for diagnosis of IUGR when compared with FL, HC, FL/AC and HC/AC. AC has got lowest FP and FN with a highest accuracy rate at both 22-24 weeks of gestational age and 32-34 weeks of gestational age. The sensitivity, specificity and accuracy of AC is more at 32-34 weeks of gestation than at 22-24 weeks for diagnosis of IUGR.


2016 ◽  
Vol 7 (2) ◽  
pp. 37-41
Author(s):  
Sandhya Hemraj ◽  
Sally M Abraham ◽  
US Vinayaka ◽  
G Ravichandra ◽  
Devdas Acharya

ABSTRACT Background Gestational age estimation is one of the most important information conveyed by a sonologist when performing an obstetric ultrasound examination. The traditional fetal biometric parameters, such as biparietal diameter (BPD), head circumference (HC), femur length (FL), and abdominal circumference become increasingly unreliable for accurate gestational age estimation with advancing pregnancy, especially in 3rd trimester. This study was conducted to assess the role of fetal kidney length (KL) as an alternate parameter to assess gestational age in 2nd and 3rd trimesters. Aim To assess relationship between sonographic gestational age and fetal KL between 18 and 39 weeks of gestation. Settings and design Prospective, cross-sectional, single operator study conducted over a period of 1 year in a medical college hospital. Materials and methods Three hundred singleton pregnant women between 18 and 39 weeks of gestation were subjected to antenatal ultrasound. In addition to routine fetal biometry, measurements of fetal KL were made by noting distance between upper and lower poles of each kidney on a sagittal section of the fetal abdomen. The right and left KLs were averaged to obtain a single value for the purpose of statistical analysis. Statistical analysis Statistical analysis is done using SAS 9.2, SPSS 15.0, Stata 10.1, Med Calc 9.0.1, Systat 12.0, and R environment version 2.11.1. Fetal KL was expressed as mean ± standard deviation. Linear regression analysis was used to establish a relationship between sonographic gestational age in weeks and fetal KL. Level of significance was expressed as p value. Results A strong statistical correlation was found between sonographic gestational age and fetal KL. Nomograms and growth curves were constructed to correlate gestational age with fetal KL. Conclusion Fetal KL measurements can be used as alternate method of estimating gestational age in women with uncertain last menstrual periods (LMPs) and presenting late in the gestation for safe confinement. In fetal macrocephaly, hydrocephalus, short-limb dysplasias, and when fetal head is engaged, these measurements are valuable alternate parameters to assess gestational age since they are simple, not time-consuming, easy to identify, and measure. How to cite this article Hemraj S, Abraham SM, Acharya D, Ravichandra G, Vinayaka US. Sonographic Correlation of Gestational Age with Fetal Kidney Length. Int J Infertil Fetal Med 2016;7(2):37-41.


2017 ◽  
Vol 13 (1) ◽  
pp. 225-228
Author(s):  
V Natraj Prasad ◽  
Vivek Dhakal ◽  
Pramod Kumar Chhetri

Background & Objectives: Estimation of the length of gestation is of paramount importance to obstetricians. The fetal cerebellum grows progressively along gestational period and transverse cerebellar diameter can be used as a new biometric parameter to assess the gestational age of fetus. This study was done to evaluate the accuracy transverse cerebellar diameter against other regularly measured parameters like biparietal diameter, head circumference, abdominal circumference and femur length in pregnant women between 15 to 40 weeks of gestation.Materials & Methods: In this study of 60 pregnant women between 15-40 weeks of gestation, all the parameters like biparietal diameter, head circumference, abdominal circumference, femur length and transverse cerebellar diameter were measured with ultrasonography. The measured values were then correlated with gestational age using regression coefficient.Results: Gestational age estimated by transverse cerebellar diameter (R2 = 0.989; p < 0.001) had good predictive value which was comparable to gestational age estimated by biparietal diameter (R2 =0.929; P < 0.01), head circumference (R2 =0.964; P < 0.01), abdominal circumference (R2 =0.931; P < 0.01) and fetal length (R2 = 0.966; P < 0.01). Conclusion: Transverse cerebellar diameter has a good predictive accuracy for gestational age estimation which is comparableto other routinely used parameters and can be used as an alternative parameter to predict the gestational age.


Author(s):  
Premlata Mital ◽  
Richa Ainani ◽  
Nupur Hooja ◽  
Priya Sonkhya ◽  
Vishwas Pradodh ◽  
...  

Background: Accurate knowledge of gestational age of the foetus is essential for planning a timely and uneventful outcome. Biparietal diameter, head circumference, abdominal circumference and femur length reliably predict gestational age. The humerus length is not widely used as biometric parameter for determining the GA so the present study was done to estimate foetal gestational age by measuring humerus length between 18 to 36 weeks of normal singleton pregnancies and to compare humerus length with routine parameters.Methods: This was a hospital based descriptive cross-sectional study, 200 women with viable singleton pregnancy, with known LMP, between 18 weeks to 36 weeks of gestation were included. Various foetal measurements such as biparietal diameter, head circumference, abdominal circumference, femur length and humerus length were measured using electronic calipers on ultrasound. Data were statistically analyzed.Results: The mean humerus length at 18 weeks was 25.27±1.16 mm and at 36 weeks of gestation was 57.11±1.58 mm. Simple linear regression analysis shows a strongly significant linear relationship between humerus length and gestational age. Where, gestational age (weeks) Y= 0.5213 x humerus length (X) + 4.905; with high degree of correlation coefficient (R2 =0.9785 and P≤0.0001). When Compared with BPD, HC, AC and FL, humerus length also shows a linear correlation.Conclusions: The measurement of the humerus length can be an important additional parameter for estimating gestational age along with other parameters and can be used to predict the gestational age of fetuses in special circumstances.


Author(s):  
Dipali Kadam ◽  
Saurabh Patil ◽  
Meenal Jain

Background: Gestational Age (GA) is one of the most imperative parameters required for proper management in pregnancy. Routinely GA is estimated by sonography utilising Biparietal Diameter (BPD), Femur Length (FL), Abdominal Circumference (AC) and Head Circumference (HC). In any case, these parameters have some limitations. Hence, there is need to find other parameters that may complement the established fetal biometric parameters in predicting GA. The objective of the present study was to assess placental thickness in second and third trimester pregnancies and its relationship with fetal gestational age and its role in detecting LBW and IUGRMethods: A cross sectional prospective study was carried out in three hundred pregnant women between 13 to 40 weeks of gestation, who came for routine antenatal sonography. Placental thickness was measured along with routine parameters. Placental thickness was measured at the level of umbilical cord insertion by two-dimensional ultrasonography.Results: Correlation between the GA by LMP and Placental thickness by ultrasound was done by using Karl Pearson's Correlation(r). The values were expressed as mean + standard deviation. Correlation between placental thickness and gestational age was statistically significant as p value is <0.01. Placental thickness measured in millimetres increases with gestational age in second and third trimester.Conclusions: The correlation between the placental thickness and gestational age was linear and direct. Therefore, Placental thickness is used as a predictor for estimation of gestational age of the fetus in cases where LMP is not known and in detecting developing IUGR and low birth weight.


Biomedicine ◽  
2021 ◽  
Vol 40 (4) ◽  
pp. 436-441
Author(s):  
Kalpana Ramachandran ◽  
Arunthathy Gnaneshwar ◽  
Robert Dinesh Kumar ◽  
Parvathavarthine CR ◽  
Sri Santhana Krishnan V

Introduction and Aim: Gestational age assessment in women with indeterminate last menstrual period has always remained an enigma. Though multiple parameters have been found useful in providing an indirect age assessment, various studies have now shown that the ultrasonographic measurement of foetal kidney length during the second and third trimester of pregnancy is a viable alternative in foetal age assessment. Methods: This prospective study was conducted among the antenatal women with singleton uncomplicated pregnancy during 18 to 40 weeks of gestation attending the outpatient department for routine ultrasound foetal biometry in a tertiary care referral institution in South India, during January 2019 to June 2019. A total of hundred and thirty-five antenatal mothers were included in this study. Data entry was done in Microsoft Excel and data analysis was done using Statistical Package for Social Sciences (SPSS). Results: There was a strong positive correlation between GA and MKL. Regression model (Model 1) for Mean kidney length showed significant correlation and regression models (Model 2) for MKL and routine foetal biometric parameters like biparietal diameter, femur length and abdominal circumference were found to be significantly correlated. Conclusion: Mean foetal kidney length can alone predict gestational age and by combining it with the other biometric indices to give a better estimation of gestational age.


Sign in / Sign up

Export Citation Format

Share Document