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

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.

Author(s):  
Samta Solanki ◽  
Anusha S ◽  
B S Meena

Background: Ultrasonographic assessment of gestational age by using different foetal parameter such as BPD, FL, AC are highly reliable in first and second trimester in pregnancy. In third trimester reliability of any single parameter has limitations. Methods: This was a hospital based comparative cross-sectional study done in the Department of Obstetrics and Gynaecology, S.M.S. Medical College and attached hospitals, Jaipur, Rajasthan. The period of study was from June 2018 to October 2019. Results: The mean TCD at 15 weeks and 40 weeks was 15.00 ± 0.00mm and 53.33±1.155mm respectively. The mean BPD at 16 weeks and 40 weeks was 33.50±0.70mm and 93±1.528mm respectively. The mean HC at 15 weeks and 40 weeks was 111.00±1,41mm and 340±2.00mm respectively. The mean FL at 15 weeks and 40 weeks was 18.50±0.70mm and 77.67±1.528mm respectively. The mean AC at 15 weeks and 40 weeks was 99.00±1.41mm and 365.33±8.32mm respectively. Conclusion:  We conclude that foetal transcerebellar diameter can thus be used as an alternative foetal parameter to assess gestational age and can be used in cases of wrong dates or when other routine parameters are not conclusive or did not accurately predict gestational age for e.g. in cases of hydrocephalus, brachycephaly, dolicocephaly, intrauterine growth restriction, achondroplasia or short limb dwarfism. Keywords: Gestational age, Linear regression, BPD


2020 ◽  
Vol 8 (3) ◽  
pp. 131-135
Author(s):  
Muna Badu ◽  
Shankar Bahadur Singh Rajbhandari ◽  
Pashupati Regmi

Background: Gestational age and fetal weight estimation by ultrasound is the most effective and accurate method to date pregnancy. Ultrasound has been used to characterize placental position and morphologic changes. Placental thickness could be one additional parameter to assess gestational age and fetal weight. Objectives: This study aims to investigate the relationship between placental thickness with gestational age and fetal weight in third trimester of pregnancy in primigravida. Methodology: Prospective hospital based cross sectional study was conducted including 111 primigravida in third trimester with normal singleton pregnancies in Department of Radiology of Kathmandu Medical College Teaching Hospital from November 2018 to February 2019. Patients with known medical and obstetrical complications were excluded from the study. Placental thickness in millimeters was measured at the level of insertion of the umbilical cord. Pearson’s correlation analysis was used for analyzing variables and p-value <0.05 was considered statistically significant. Results: Mean age of participants was 28.3 ± 4.79 years. Posterior location of the placenta was most common (35%). Placental thickness correlated well with the gestational age and fetal weight. Pearson correlation coefficient was found to be 0.645 for placental thickness with gestational age and 0.598 for placental thickness with fetal weight. P-value was <0.001 in both, showing positive correlation of mentioned variables with placental thickness. Conclusion: Placental thickness can be a new and reliable parameter for estimation of gestational age and fetal weight. It can be routinely used during antenatal checkup.


2020 ◽  
Vol 20 (4) ◽  
pp. 1927-32
Author(s):  
Sanjay Mishra ◽  
Surajit Ghatak ◽  
Pratibha Singh ◽  
Dushyant Agrawal ◽  
Pawan Garg

Objectives: To determine accuracy of transverse cerebellar diameter (TCD) measurement in the prediction of gestational age (GA) in normal fetuses; to develop reference chart for TCD according to GA in Indian population. Design: A retrospective cross-sectional study. Method: Ultrasonographic measurements in 300 singleton pregnant women included biparietal diameter (cm), head circum- ference (cm), abdominal circumference (cm), femur length (cm) and transverse cerebellar diameter (cm). Reference chart with mean TCD for corresponding gestational age (GA) in weeks was developed. Results: Statistically significant relationship found between TCD and gestational age (R2=0.92, p=0.0006). Regression for- mulae based on TCD with other parameter can be used to predict gestational age of foetus. When TCD is compared with findings in other studies in different ethnic population, it is found that there is significant difference exists. Conclusion: In normally developing fetuses the TCD has linear correlation with advancing gestational age. A separate refer- ence chart is required for every different population because ethnicity, nutrition and environmental factors can have impact on normal TCD values. This will help to avoid misinterpretation of data to determine gestational age. Keywords: Transverse cerebellar diameter; ultrasonography; gestational age.


Author(s):  
Rintu George ◽  
Umamageswari Amirthalingam ◽  
Mohamed Rafi Kathar Hussain ◽  
Vigneshwar Aditiya ◽  
A. M. Anand ◽  
...  

Abstract Background Estimation of gestational age plays a pivotal role in day to day clinical practice for appropriate management of newborn. The trans-cerebellar diameter can predict gestational age in cases of variations of fetal head shape such as dolichocephaly and brachycephaly or even when fetus is in posterior position. Trans-cerebellar diameter (TCD) may be useful in gestational age estimation. Aim and methodology To determine the accuracy of trans-cerebellar diameter in the estimation of gestational age of fetus and comparing the conventional parameters like head circumference, biparietal diameter, abdominal circumference and femur length in the measurement of gestational age. This is a prospective, cross-sectional analytical study done in the Radiology Department in those patients who were referred to the department for a routine antenatal ultra-sonogram checkup. Results Comparison of trans-cerebellar diameter with gestational age derived from last menstrual period indicates that there is a linear relationship throughout the gestational ages. There is a strong correlation of trans-cerebellar diameter with other conventional parameters namely biparietal diameter, femur length and abdominal circumference of which Femur length correlates well with the trans-cerebellar diameter. Correlation of transcerebellar diameter with gestational age shows a R2 of 0.995 (p value < 0.001). Conclusion Trans-cerebellar diameter is best in estimation of gestational age when compared to biparietal diameter, femur length and abdominal circumference. The regression formula derived from trans-cerebellar diameter measurement can be applied to determine the gestational age of fetus.


2019 ◽  
pp. 1-3
Author(s):  
Mounika. V.

Introduction: Ultrasonography is being a painless, non-invasive, non-ionizing,portable, redoable and relatively inexpensive modality used to evaluate fetal growth parameter many times during pregnancy. Aim: To assess relationship between sonographic gestational age and fetal HUMERUS length between 16 and 39 weeks of gestation and to compare its accuracy with other biometric parameters. Materials and Methods: Prospective cross sectional study was performed on 500 normal singleton pregnancies at second and third trimesters between 16-39 weeks The study was conducted on a gray scale real-time ultrasound scanner using linear and sector transducers to measure the standard fetal biometrics and fetal humeral length. Results: Biparietal diameter (BPD), Head circumference (HC), Abdominal circumference (AC), and Femur length (FL) were compared with standard charts and scatter graphs were plotted. Coefficient of correlation were calculated which were for BPD, HC, AC, and FL, respectively, proving them reliable indicators. HL measured in the present study was compared with standard nomogram. A statistically significant curvilinear correlation was found between the HL and GA indicating it to be a reliable indicator of GA. Significant coefficient of correlation (0.16) was observed between HLand GAindicating it to be a reliable parameter. Conclusion: The HLwas most accurate parameter next to FLin assessing GA. The study also indicates that combination of BPD, HC, AC, FL, HL is more accurate in predicting GA than any single parameter, particularly in the third trimester of pregnancy. HL would contribute to maximum accuracy next to FLamongst all the parameters


2018 ◽  
Vol 14 (6) ◽  
pp. 375
Author(s):  
M. Lutfor Rahman ◽  
Aysha Sultana ◽  
Kalyan Das

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.


2017 ◽  
Vol 4 (3) ◽  
pp. 836
Author(s):  
Ravindernath M. L. ◽  
Mahender Reddy ◽  
Nihar Reddy

Background: Assessment of accurate gestational age of fetus is very imperative for proper obstetric management of normal as well as IUGR pregnancies. The objective of this study was to evaluate the accuracy of transverse cerebellar diameter as against the conventional parameters of Biparietal diameter, head circumference, abdominal circumference and femur length in normal pregnant mothers between 15 to 40 weeks and in antenatal diagnosis of intrauterine growth retardation.Methods: Study done on 100 women attending antenatal department, 80 were normal pregnancy cases and 20 were clinically suspected IUGR cases. In each patient BPD, HC, AC, FL and TCD was measured. Correlation of TCD was done with other measured parameters as well as with estimated gestational age of fetus.Results: There was no statistically significant difference between the age and parity distributions of two groups It was seen that 18 cases were below the fifth percentile for AC and HC, 19 cases were below the fifth percentile for BPD and 16 cases were below the fifth percentile for FL. In 16 out of 20 cases the TCD values were within the normal range. Only in 4 cases the TCD values were below the 5th percentile. This difference in number of cases below the 5th percentile for BPD, HC, AC, FL and TCD was statistically significant (p-value=0.001). In 20 IUGR cases the gestational age predicted by transverse cerebellar diameter measurements closely correlated with gestational age predicted by last menstrual period.Conclusions: It was found that there is good correlation between TCD and other parameters. Also, TCD shows good correlation with gestational age. It is better than BPD in circumstances like excessive moulding and dolichocephaly. Also, TCD measurement is not fraught with problems as encountered in FL measurement.


2021 ◽  
Author(s):  
Nazanin Farshchian ◽  
Ali Naghdian ◽  
Parisa Bahrami Kamangar

Postdate pregnancy is a pregnancy that pasts more than forty weeks. This can be dangerous for the mother, fetus, and newborn. By knowing the most appropriate ultrasound criteria in predicting the probability of postdate pregnancy, its complications can be reduced by taking timely measures. Therefore, the present study was conducted with the aim of determining the relationship between ultrasound criteria in determining the age of postdate fetuses. This cross-sectional study (descriptive-analytical type) was done in Kermanshah Imam Reza Hospital on 33 pregnant women that, according to LMP and first-trimester ultrasound, pregnancy age was more than 40 weeks. Gestational age was calculated by various ultrasound criteria, including head circumference measurement (HC), Abdominal Circumference (AC), Biparietal Diameter (BPD), femur length (FL), and Transcerebellar Diameter (TCD). The findings were compared with calculated age by LMP. Data were analyzed by SPSS16 software. Correlation rate of pregnancy age based on LMP with FL (R=0.576, P<0.001), AC (R=0.208, P=0.245), BPD (R= -0.200, P=0.264), HC (R= -0.211, P=0.238) and TCD were (R=0.111, P=0.538). The pregnancy age correlation rate based on LMP with ultrasound criteria in general was (R=0.140, P=0.436). There was a direct relationship between gestational age based on LMP with FL, AC, TCD and inversely related to BPD and HC. Among the sonographic criteria, only the FL criterion was significantly correlated with LMP. In general, the correlation between gestational age based on LMP and ultrasound was not statistically significant.


Author(s):  
Sandesh Ganjoo ◽  
Shalini Devgan ◽  
Ghanshyam Dev

Background: Placental thickness (PT) is the easiest placental dimension to measure, yet little is known about the normal PT. The aim of this study was to determine the normal, sonographically measured PT in millimetre (mm) in the second trimester and to determine if this measurement can be adjusted for gestational age for that time and evaluate its relationship with femur length and biparietal diameter of the fetus.Methods: The study was a cross sectional observational study, recruiting 100 consecutive, singleton pregnancies, reporting for ultrasonography (USG) between 14 weeks and 24 weeks of gestation, having undergone at least one ultrasonogram in the first trimester, with known last menstrual period (LMP). The placental thickness was measured perpendicular to the uterine wall, through the placenta at the site of cord insertion.Results: The average age of study population was 24.96 with a standard deviation (SD) of 2.70 years with the minimum age being 18 years and maximum age being 32 years. Regression analysis yielded the following mathematical relationships between PT, Gestational age (GA), Biparietal diameter (BPD) and Femur length (FL) in the second trimester. Y(PT)= 0.9366x (Gestation age)+1.655, R2 = 0.7332; Y(PT)= 0.2872x(BPD)+6.9578, R2= 0.7314; Y(PT)=0.2995x(FL)+ 10.03, R2 = 0.6186Conclusions: PT in present study showed a positive linear correlation with gestational age, FL and BPD in second trimester. Also, it can be concluded that PT may be used as a predictor of GA in women with unknown LMP.


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.


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