Fetal kidney length as a parameter for determination of gestational age from 20th week to term in healthy women with uncomplicated pregnancy

2017 ◽  
Vol 5 (5) ◽  
pp. 1869 ◽  
Author(s):  
Monalisa Peter ◽  
Ajit Kumar Nayak ◽  
Prajna Paramita Giri ◽  
Manju Kumari Jain
Keyword(s):  
Gestational Age ◽  
Abdominal Circumference ◽  
Fetal Kidney ◽  
Cross Sectional ◽  
Crown Rump Length ◽  
Fetal Biometry ◽  
Healthy Women ◽  
Uncomplicated Pregnancy ◽  
Kidney Length ◽  
Biometric Indices

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.

scholarly journals Determination of Gestational Age by Fetal Kidney Length Measurement after the 20th Week in Healthy Women with Uncomplicated Pregnancy in Tertiary Care Centre

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Joshi BR ◽  
◽  
Chaurasia AK ◽  
Khanal UP ◽  
◽  
...  
Keyword(s):  
Gestational Age ◽  
Linear Correlation ◽  
Head Circumference ◽  
Abdominal Circumference ◽  
Fetal Kidney ◽  
Uncomplicated Pregnancy ◽  
Biparietal Diameter ◽  
Study Results ◽  
Kidney Length

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.

scholarly journals Sonographic Correlation of Gestational Age with Fetal Kidney Length

2016 ◽  
Vol 7 (2) ◽  
pp. 37-41
Author(s):  
Sandhya Hemraj ◽  
Sally M Abraham ◽  
US Vinayaka ◽  
G Ravichandra ◽  
Devdas Acharya
Keyword(s):  
Statistical Analysis ◽  
Gestational Age ◽  
Age Estimation ◽  
Linear Regression Analysis ◽  
Abdominal Circumference ◽  
P Value ◽  
Fetal Kidney ◽  
Fetal Biometry ◽  
Kidney Length ◽  
Gestational Age Estimation

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.

scholarly journals Evaluation of ultrasonographic fetal kidney length for gestational age detection in late second and third trimesters

2020 ◽  
Vol 3 (4) ◽  
pp. 01-09
Author(s):  
Amal S. Zaghloul
Keyword(s):  
Gestational Age ◽  
Abdominal Circumference ◽  
Accurate Estimation ◽  
Multiple Gestation ◽  
Fetal Kidney ◽  
Third Trimester ◽  
Femur Length ◽  
Rate Of Increase ◽  
Kidney Length ◽  
The Mean

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.

scholarly journals Can trans-cerebellar diameter supersede other fetal biometry in measuring gestational age? A prospective study

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Rintu George ◽  
Umamageswari Amirthalingam ◽  
Mohamed Rafi Kathar Hussain ◽  
Vigneshwar Aditiya ◽  
A. M. Anand ◽  
...  
Keyword(s):  
Gestational Age ◽  
Abdominal Circumference ◽  
Radiology Department ◽  
Fetal Head ◽  
Cross Sectional ◽  
Femur Length ◽  
Fetal Biometry ◽  
Biparietal Diameter ◽  
A Prospective Study ◽  
Gestational Age Estimation

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.

scholarly journals Chinese Fetal Biometry: Establishment of a Formula for Calculating Gestational Age based on Crown–Rump Length Measurements

2021 ◽  
Author(s):  
Yixiu Zhang ◽  
Hua Meng ◽  
Yuxin Jiang ◽  
Zhonghui Xu ◽  
Yunshu Ouyang ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Gestational Age ◽  
Prediction Error ◽  
Polynomial Regression ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Crown Rump Length ◽  
Fetal Biometry ◽  
Fractional Polynomial ◽  
The Mean

Abstract Background: To develop an ultrasonographic dating formula for predicting gestational age (GA) based on fetal crown–rump length (CRL) in a Chinese population, evaluate its systematic prediction error and compare it with existing formulae.Methods: This was a prospective cross-sectional study of spontaneously conceived singleton pregnancies among women with a regular menstrual cycle in the preceding year. Ultrasound examinations were performed at 11–14 weeks according to the date of the last menstrual cycle. The CRL was measured three times for each fetus, and the mean was used to derive the best-fit fractional polynomial regression model for estimation of GA in relation to CRL. For each fetus, the GA was compared with the GA calculated using six established dating formulae based on CRL measurements. The means of the differences between estimated and menstrual age were calculated for each formula. All the women were followed up routinely until the birth of the fetus. Results: Of the 4710 subjects recruited, the mean and standard deviation values of CRL changed linearly with GA. The corresponding regression equation and its correlation coefficient (R2) was GA = 59.361513 + 0.461425 ´ CRL (R2 = 0.8028). The mean difference between estimated and menstrual age was 0.22 days (95% confidence interval 0.05–0.21), lower than that of the six existing CRL dating formulae.Conclusions: We have derived a CRL-based dating formula suitable for naturally conceived pregnancies for GA between 11+0 and 13+6 weeks. The formula has no systematic prediction error, comparing favorably with the existing published dating formulae.

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 ◽  
◽  
Keyword(s):  
Correlation Coefficient ◽  
Gestational Age ◽  
Head Circumference ◽  
Sagittal Plane ◽  
Abdominal Circumference ◽  
Fetal Kidney ◽  
Femur Length ◽  
Interclass Correlation Coefficient ◽  
Interclass Correlation ◽  
Kidney Length

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.

scholarly journals Role of mean fetal kidney length as an additional parameter in late trimester for accurate estimation of gestational age relative to other biometrics indices

2020 ◽  
Vol 9 (9) ◽  
pp. 3724
Author(s):  
Shalini Sahay ◽  
Manju Sharma ◽  
Devendra Kumar ◽  
Bhawar Singh Meena
Keyword(s):  
Risk Factors ◽  
Gestational Age ◽  
Accurate Estimation ◽  
Additional Parameter ◽  
Fetal Kidney ◽  
Medical Risk ◽  
Medical Risk Factors ◽  
Kidney Length ◽  
Biometric Indices

Background: As biometric indices are difficult to obtain or show gross discrepancies with each other or with gestational age in the late trimester, so for accurate dating additional parameter is required. Fetal kidney length is easy to measure and appear reliable in previous studies.Methods: Well dated 121 antenatal women from 28 to 40 weeks of gestation with no obstetric or medical risk factors were recruited and kidney length is assessed in longitudinal scan and maximum length is taken. fetal kidney length derived gestational age compared with other biometrics indices gestational age.Results: Mean kidney length showed significant correlation (r=0.899, p<0.001 value) with increasing gestational age. Mean kidney length dated pregnancy within ±8.5 days.Conclusions: Fetal kidney length measurement correlated well with other routinely used parameters for the estimation of gestational age and can be used as an accurate parameter to date pregnancy in the late trimester.

scholarly journals Determination of gestational age: correlation between foetal biometry and transverse cerebellar diameter in women with uncomplicated pregnancy

2017 ◽  
Vol 6 (8) ◽  
pp. 3599
Author(s):  
Pavithra S. N. ◽  
Vimala D. ◽  
Prema priya G. ◽  
Shankar R.
Keyword(s):  
Gestational Age ◽  
Third Ventricle ◽  
Antenatal Clinic ◽  
Cross Sectional Study ◽  
Abdominal Circumference ◽  
Cross Sectional ◽  
Medical College ◽  
Uncomplicated Pregnancy ◽  
Biparietal Diameter ◽  
Biometric Parameter

Background: Transverse Cerebellar Diameter (TCD) serves as a reliable predictor of gestational age in foetus and is a standard against which aberrations in other foetal parameters can be compared, especially when the GA cannot be determined by the date of last menstrual period or early pregnancy scan, TCD is one foetal parameter that has remained consistently superior in predicting gestational age in both singleton and twin gestation. Aim of the study was to assess and evaluate the effectiveness of transverse cerebellar diameter by using ultrasonography for determining the gestational age of the foetus.Methods: A cross-sectional study was done in 100 uncomplicated pregnant patients between the 15th week of gestation to term referred from routine antenatal clinic in outpatient and in-patient department of Obstetrics and Gynecology department of Vinayaka Mission Krupananda Variyar medical college and hospital, Salem during study period April 2015-March 2016. TCD is obtained in the axial plane in the cerebellar view i.e. with a slight rotation of the transducer approximately 30° from the conventional thalamic plane where the biparietal diameter is measured using the cavum septi pellucidi, third ventricle and thalami as landmarks.Results: The correlation of transcerebellar diameter (TCD) with that of BPD (bi-parietal diameter) had shown a perfect positive correlation (r = 0.978) and a similar type of correlation was also seen with HC (head circumference) (r = 0.979), AC (abdominal circumference) (r = 0.966), FL (femur length) (r = 0.976) and USG GA (ultrasonogram gestational age) (r = 0.983).Conclusions: In the normally developing foetus, the TCD increases in a linear fashion with advancing gestational age. The data of this study suggest foetal TCD on ultrasound is a reliable predictive biometric parameter of gestational age.

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