scholarly journals Is Cardiomegaly an Indication of “Heart-Sparing Effect” in Small Fetuses?

2021 ◽  
pp. 1-7
Author(s):  
Silvia Salvi ◽  
Laura D’Emidio ◽  
Michael Roughton ◽  
Sara De Carolis ◽  
Antonio Lanzone ◽  
...  
Keyword(s):  
Higher Dimensions ◽  
Long Bones ◽  
Intrauterine Environment ◽  
Femur Length ◽  
Biparietal Diameter ◽  
Cardiac Adaptation ◽  
Heart Size ◽  
Sparing Effect ◽  
Insight Into ◽  
Estimated Fetal Weight

<b><i>Introduction:</i></b> This study aimed to test the hypothesis that cardiac size is maintained in small fetuses presenting with cardiomegaly. <b><i>Materials and Methods:</i></b> We identified singleton fetuses with estimated fetal weight &#x3c;10th centile and with cardiomegaly without another more likely cardiac or extra-cardiac cause. We used <i>Z</i>-scores for cardiac and thoracic circumferences normalized for gestational age (GA), biparietal diameter (BPD), head circumference (HC), and femur length (FL), obtained from 188 normally grown fetuses. <b><i>Results:</i></b> When comparing chest size, small fetuses had significantly lower thoracic circumferences median <i>Z</i>-scores (IQR) for GA = −4.82 (−6.15 to −3.51), BPD = −2.42 (−4.04 to −1.48), HC = −2.72 (−4.53 to −1.90), and FL = −1.60 (−2.87 to −0.71); <i>p</i> &#x3c; 0.001 for all. When comparing heart size, small fetuses showed lower cardiac circumferences median <i>Z</i>-scores (IQR) for GA = −1.59 (−2.79 to −0.16); <i>p</i> &#x3c; 0.001, similar cardiac circumferences <i>Z</i>-scores for BPD = 0.29 (−0.65 to 1.28); <i>p</i> = 0.284 and HC = 0.11 (−1.13 to 0.96); <i>p</i> = 0.953, and higher cardiac circumferences <i>Z</i>-scores for FL = 0.94 (−0.05 to 2.13); <i>p</i> &#x3c; 0.001. <b><i>Conclusions:</i></b> Our results show that in small fetuses with cardiomegaly, the heart maintains normal dimensions when normalized to cranial diameters and higher dimensions when normalized to long bones. This provides insight into cardiac adaptation to adverse intrauterine environment.

scholarly journals A comparison of ultrasound with magnetic resonance imaging in the assessment of fetal biometry and weight in the second trimester of pregnancy: An observer agreement and variability study

Ultrasound ◽  
2018 ◽  
Vol 26 (4) ◽  
pp. 229-244 ◽  
Author(s):  
Jacqueline Matthew ◽  
Christina Malamateniou ◽  
Caroline L Knight ◽  
Kelly P Baruteau ◽  
Tara Fletcher ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Random Error ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Resonance Imaging ◽  
Intra Class Correlation ◽  
Femur Length ◽  
Biparietal Diameter ◽  
Estimated Fetal Weight

Objective To compare the intra and interobserver variability of ultrasound and magnetic resonance imaging in the assessment of common fetal biometry and estimated fetal weight in the second trimester. Methods Retrospective measurements on preselected image planes were performed independently by two pairs of observers for contemporaneous ultrasound and magnetic resonance imaging studies of the same fetus. Four common fetal measurements (biparietal diameter, head circumference, abdominal circumference and femur length) and an estimated fetal weight were analysed for 44 ‘low risk’ cases. Comparisons included, intra-class correlation coefficients, systematic error in the mean differences and the random error. Results The ultrasound inter- and intraobserver agreements for ultrasound were good, except intraobserver abdominal circumference (intra-class correlation coefficient = 0.880, poor), significant increases in error was seen with larger abdominal circumference sizes. Magnetic resonance imaging produced good/excellent intraobserver agreement with higher intra-class correlation coefficients than ultrasound. Good interobserver agreement was found for both modalities except for the biparietal diameter (magnetic resonance imaging intra-class correlation coefficient = 0.942, moderate). Systematic errors between modalities were seen for the biparietal diameter, femur length and estimated fetal weight (mean percentage error = +2.5%, −5.4% and −8.7%, respectively, p < 0.05). Random error was above 5% for ultrasound intraobserver abdominal circumference, femur length and estimated fetal weight and magnetic resonance imaging interobserver biparietal diameter, abdominal circumference, femur length and estimated fetal weight (magnetic resonance imaging estimated fetal weight error >10%). Conclusion Ultrasound remains the modality of choice when estimating fetal weight, however with increasing application of fetal magnetic resonance imaging a method of assessing fetal weight is desirable. Both methods are subject to random error and operator dependence. Assessment of calliper placement variations may be an objective method detecting larger than expected errors in fetal measurements.

The Influence of Birth Order and Presentation on Intrauterine Growth of Twins

1993 ◽  
Vol 42 (2) ◽  
pp. 151-158 ◽  
Author(s):  
I. Blickstein ◽  
R. Namir ◽  
A. Weissman ◽  
Y. Diamant
Keyword(s):  
Birth Order ◽  
Growth Curves ◽  
Abdominal Circumference ◽  
Adaptive Mechanism ◽  
Vertex Group ◽  
Femur Length ◽  
Intrauterine Growth ◽  
Biparietal Diameter ◽  
Biometric Indices ◽  
Estimated Fetal Weight

AbstractIn order to evaluate the influence of birth order and fetal presentation on antenatal growth of twins we conducted a comparison of prospective measurements of five fetal biometric indices in 50 vertex-vertex and 47 vertex-breech twins. We compared (a) twin A to twin B in both groups; (b) the second and (c) the first twins of both groups. Both groups had similar maternal and neonatal characteristics. The growth curves of the twins were also very similar except for three significant (p<0.05) deviations: (a) Twin A of the vertex-vertex group, had larger femur length (FL) at 18-19 weeks, abdominal circumference (AC) and estimated fetal weight (EFW) at 29 weeks, and EFW measurements at 36 weeks, (b) Second breech twins, compared to their second vertex cohorts, had significantly smaller biparietal diameter (BPD), head circumference (HC) and FL at 18-19 weeks, BPD and HC at 29 weeks, and EFW at 37 weeks, (c) First twins of the vertex-breech group, as compared to first twins of the vertex-vertex group, had significantly smaller BPD and AC at 18-19 weeks, FL and AC at 21-22 and 29 weeks, FL at 31 weeks, and EFW at 27-28 and 36 weeks' gestation. We concluded that significantly different sonographic fetal indices may be measured at about 20 and 30 weeks' gestation, but not later. An adaptive mechanism attributed to fetal presentation is suggested to explain similar birthweights in spite of these antepartum differences.

Estimated Fetal Weight in Twin Pregnancy: How Good Are We?

1990 ◽  
Vol 39 (3) ◽  
pp. 395-399 ◽  
Author(s):  
D.M. Campbell ◽  
A.P. Smith ◽  
A.W. Wilson
Keyword(s):  
Multiple Pregnancy ◽  
Fetal Weight ◽  
Singleton Pregnancy ◽  
Femur Length ◽  
Biparietal Diameter ◽  
Multiple Measurements ◽  
Ultrasonic Assessment ◽  
Twin Pregnancies ◽  
Estimated Fetal Weight ◽  
Singleton Pregnancies

AbstractUltrasonic assessment of fetal weight derived from multiple measurements of the fetus has become accepted in clinical practice as being useful in singleton pregnancies. Several different formulae for estimating fetal weight have been derived from differing measurements of the fetus, such as biparietal diameter, trunk circumference, and femur length. To date, there has been no attempt to evaluate such a technique in multiple pregnancy. This study aims to see whether the formulae derived for singleton pregnancy are applicable to twin pregnancies. Estimated fetal weight will be derived by mathematical modelling from ultrasonic measurements made within a week of delivery and the results compared with the actual birthweight to give an indication of how good such estimated fetal weights are. Factors to be considered in the analysis include whether there are differences between Twin I and Twin II, differences of presentation with twins and differences by gestation at delivery.

scholarly journals Placental thickness: an important parameter in determining gestational age and fetal growth during ANC scan

2018 ◽  
Vol 7 (11) ◽  
pp. 4619
Author(s):  
Dipali Kadam ◽  
Saurabh Patil ◽  
Meenal Jain
Keyword(s):  
Gestational Age ◽  
Abdominal Circumference ◽  
P Value ◽  
Third Trimester ◽  
Cross Sectional ◽  
Femur Length ◽  
Biparietal Diameter ◽  
Antenatal Sonography ◽  
Umbilical Cord Insertion ◽  
Placental Thickness

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.

scholarly journals Correlation models for monitoring fetal growth

2020 ◽  
Vol 29 (10) ◽  
pp. 2795-2813 ◽  
Author(s):  
Yuan Feng ◽  
Luo Xiao ◽  
Cai Li ◽  
Stephanie T Chen ◽  
Eric O Ohuma
Keyword(s):  
Fetal Growth ◽  
Abdominal Circumference ◽  
Fetal Head ◽  
Femur Length ◽  
Second Stage ◽  
Correlation Models ◽  
Biparietal Diameter ◽  
Z Scores ◽  
Using Data ◽  
Shiny Application

Ultrasound growth measurements are monitored to evaluate if a fetus is growing normally compared with a defined standard chart at a specified gestational age. Using data from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st project, we have modelled the longitudinal dependence of fetal head circumference, biparietal diameter, occipito-frontal diameter, abdominal circumference, and femur length using a two-stage approach. The first stage involved finding a suitable transformation of the raw fetal measurements (as the marginal distributions of ultrasound measurements were non-normal) to standardized deviations (Z-scores). In the second stage, a correlation model for a Gaussian process is fitted, yielding a correlation for any pair of observations made between 14 and 40 weeks. The correlation structure of the fetal Z-score can be used to assess whether the growth, for example, between successive measurements is satisfactory. The paper is accompanied by a Shiny application, see https://lxiao5.shinyapps.io/shinycalculator/ .

Antenatal diagnosis of achondroplasia

2013 ◽  
Vol 13 (1) ◽  
pp. 84-87 ◽  
Author(s):  
K Dhungel ◽  
MK Gupta ◽  
K Ahmad ◽  
S Ansari ◽  
RK Rauniyar
Keyword(s):  
Antenatal Diagnosis ◽  
Medical Science ◽  
Interesting Case ◽  
Skeletal Survey ◽  
Term Pregnancy ◽  
Femur Length ◽  
Biparietal Diameter ◽  
Ultrasound Assessment

We report a interesting case of antenatal diagnosis of achondrpoplasia in a young multigravida who presented with term pregnancy for routine ultrasound assessment which revealed a single, live intrauterine fetus with a discrepancy between femur length (FL) and biparietal diameter (BPD), narrowing of the interpeduncular distance. The diagnosis of achondroplasia was made with a sonological skeletal survey and findings were correlated with radiological skeletal survey after the baby was delivered. DOI: http://dx.doi.org/10.3329/bjms.v13i1.17443 Bangladesh Journal of Medical Science Vol. 13 No. 01 January2014: 84-87

scholarly journals P09.10: Prenatal diagnosis of achondroplasia in the second trimester of pregnancy using the biparietal diameter/femur length ratio

2017 ◽  
Vol 50 ◽  
pp. 183-183
Author(s):  
C. Veluppillai ◽  
J. Stirnemann ◽  
F. Djaafri ◽  
M. Bonniere ◽  
T. Attie Bitach ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Length Ratio ◽  
Second Trimester ◽  
Femur Length ◽  
Biparietal Diameter

scholarly journals Sonographic Reference Values for Fetal Transverse Cerebellar Diameter in the Second and Third Trimesters in a Nigerian Population

2017 ◽  
Vol 33 (3) ◽  
pp. 174-181 ◽  
Author(s):  
Charles Ugwoke Eze ◽  
Queendaline Ebere Onwuzu ◽  
Innocent Uchechukwu Nwadike
Keyword(s):  
Reference Values ◽  
Gestational Age ◽  
Head Circumference ◽  
Outer Margin ◽  
Menstrual Period ◽  
Last Menstrual Period ◽  
Abdominal Circumference ◽  
Femur Length ◽  
Biparietal Diameter ◽  
Nigerian Population

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.

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