scholarly journals EVALUATION OF FETAL THIGH CIRCUMFERENCE AS AN ADDITIONAL MARKER FOR FOETAL BIOMETRY

Author(s):  
SARYU GUPTA ◽  
BHARDWAJ ◽  
PARAMJEET KAUR ◽  
PUNEET GAMBHIR

Objective: Accurate determination of gestational age is the sine qua non of optimal management and hence prognostication of all pregnancies.A meticulous biometry ensures timely interventions resulting in favorable maternal and fetal outcomes. Traditionally, the parameters of Biparietal diameter (BPD), Femur length (FL), Head circumference (HC), and Abdominal circumference (AC) have been utilized for routine fetal biometry. The present study aims to assess the utility of Fetal Thigh Circumference (ThC) as an additional marker for fetal biometry. Methods: The present retrospective, observational, and cross-sectional study was done in the Departments of Radiodiagnosis and Obstetrics and Gynaecology in an ethically and socio-economically diverse group of pregnant females. All pregnant females with singleton pregnancies between 22 and 40 weeks of gestation and fulfilling the inclusion and exclusion criteria were subjected to ultrasound examination. Subsequently analysis was done for the data collected. Results: There were a total of 287 participants in present study group with mean age of 23±3.4 years. The strength of agreement almost perfect (>0.99) between the mean observed ThC to ThC values by Deter et al. taken as standard. There was a highly significant positive correlation between gestational period and standard biometry parameters and ThC. ThC model for prediction will be better than standard biometry parameters of BPD, HC and AC but not as good as FL model according to the regression analysis of the present study. Conclusions: There is concordance of fetal ThC as an accurate predictor of period of gestation only after FL. It can be combined with standard biometry parameters to give a better estimation of period of gestation.

1970 ◽  
Vol 39 (1) ◽  
pp. 24-27
Author(s):  
Sabrina Q Rashid

This study was conducted to determine fetal biparietal diameter and abdominal circumference ratio in Bangladesh. There is still no table of this ratio in our country. A prospective, cross-sectional study was conducted on well dated, singleton fetuses of healthy pregnant women. One table and two graphs were prepared by fitting Polynomial regression model. Percentiles, mean and two standard deviations were derived of the ratio. Fetal charts of the raw data with superimposed fitted curves were constructed. The model showed a good fit to the data of 1223 subjects. It covered 95% of the population and gave 3rd, 10th, 50th, 90th and 97th percentiles. This chart can be useful for accurate assessment of fetal biparietal diameter and abdominal circumference ratio to determine the type of fetal growth abnormality, symmetrical or asymmetrical. This is the first time that this ratio has been studied in Bangladesh. Key words: Biparietal diameter; abdominal circumference. DOI: 10.3329/bmj.v39i1.6229 Bangladesh Medical Journal 2010; 39(1): 24-27


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 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 41 (04) ◽  
pp. 410-417
Author(s):  
Johannes Knitza ◽  
Juozas Kurmanavicius ◽  
Florian Faschingbauer ◽  
Josef Wisser

Abstract Purpose To create current fetal biometry reference ranges and to compare them with references published in 1999, from the same local area in order to generate data for secular trend in fetal size. Materials and Methods Applying the same methodology as previously published, we calculated reference ranges for biparietal diameter (BPD), occipitofrontal diameter (OFD), head circumference (HC), abdominal circumference (AC) and femur length (FL) in 7863 patients examined at the obstetric clinics in a cross-sectional, prospective study in a university setting from January 2008 to December 2014. In order to compare the new reference ranges with our previously published data, we used Z-Scores and displayed the pick-up of fetal biometry data below the 5th and above the 95th percentile using the previously published reference charts. Results The comparison of the charts showed a minimal but clinically relevant increase in mean fetal body measures (BPD, HC, AC). Applying the 1999 charts to the new dataset, we would classify only 162 of 339 fetuses (47.8 %) to be correctly below the 5th percentile for AC and only 134 of 349 (38.4 %) fetuses were correctly below the 5th percentile for HC. On the other hand, the 1999 charts classified 426 instead of 332 fetuses to be above the 95th percentile for AC, which means an overestimation of 28.3 %. Conclusion Applying a similar methodology, study collective and clinical setting, our new charts showed clinically relevant differences compared to the 1999 charts. The data suggest that within one generation fetuses are getting bigger and regular updates of fetal reference charts are needed.


2014 ◽  
Vol 9 (2) ◽  
pp. 79-82
Author(s):  
A Jha ◽  
B Joshi ◽  
S Pradhan

Aims: The purpose of this study was to evaluate accuracy of trans-cerebellar diameter / abdominal circumference (TCD/AC) ratio to assess fetal growth. The ratio of TCD with head circumference (HC) and biparietal diameter (BPD) was also determined. Methods: This was a prospective cross-sectional study involving 442 women with uncomplicated singleton gestation between 15-40 weeks. Protocol included obtaining the BPD, HC, TCD and AC in conventional planes  and obtaining ratio of TCD with other biometric parameters.Results: We were able to visualize the cerebellum in about 93% of scans. The TCD/ AC ratio remained nearly constant throughout gestational age and was 0.138. The mean TCD/HC ratio was 0.124 and mean TCD/BPD ratio was 0.476.Conclusions: TCD/HC and TCD/BPD ratio showed a small increase towards the completion of gestation while TCD/AC ratio remained nearly constant throughout gestational age. TCD/AC ratio is reliable as a gestational age independent parameter of fetal growth.DOI: http://dx.doi.org/10.3126/njog.v9i2.11770   


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):  
Pavithra S. N. ◽  
Vimala D. ◽  
Prema priya G. ◽  
Shankar R.

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.


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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