Placental thickness: A Sonographic Indicator of Gestational Age in Normal Singleton Pregnancies

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Prabhat Basnet ◽  
Riddhi Adhikary

Background: Presently the most effective way to date pregnancy is by use of ultrasound. Several sonographically derived fetal parameters used to date pregnancy include fetal crown - rump length (CRL), biparietal diameter (BPD), head circumference (HC), femur length (FL),and abdominal circumference (AC). Placental thickness measured at the level of the umbilical cord insertion can be used as a new parameter to estimate gestational age of the fetus. The present study was undertaken to evaluate the relationship between placental thickness and gestational age of the fetus. Methods:  Cross-sectional study was conducted in the College of Medical Science and Teaching Hospital, Bharatpur, Nepal among 150 patients with normal singleton pregnancies presenting for routine antenatal visit of all gestational ages from 11 weeks to 40 weeks. Patients with pregnancy induced hypertension, diabetes mellitus, intrauterine growth retardation, hydrops foetalis, congenital malformation and twins are excluded. Placental thickness value, in mm, was calculated by averaging the three best measurements for each case. We studied the relationship of placental thickness, in mm, measured at the level of insertion of umbilical cord with advancing gestational age in weeks. Correlation of mean placental thickness with gestational age from 11 weeks to 40 weeks was calculated. Results: It was observed that the placental thickness gradually increased from approximately 11 mm at 11 weeks to 38.33 mm at 40 weeks of gestation. From 11 to 34 weeks of gestation, the placental thickness (in mm) almost matched the gestational age in weeks, thereafter from 35 to 40 weeks; the placental thickness was lower by 1 to 2 mm. Conclusion: The relationship between the placental thickness and gestational age was linear and direct. Placental thickness (in mm) measurement can be an important additional parameter for estimating gestational age along with other parameters especially from 11 to 34 weeks of gestation.  

2017 ◽  
Vol 4 (6) ◽  
pp. 1638
Author(s):  
Sunil Pant ◽  
Sunita Dashottar

Background: The dating of the pregnancy starts well before the fertilization has occurred because the gestational age is calculated from the first day of the last menstrual period (LMP). Accurate knowledge of the Gestational Age (GA) is the key for the good antenatal care and successful deliveries of babies. Menstrual history can be unreliable or misleading at many times. There may be fallacy in the measurement of the fetal biometric parameters in estimating the gestational age in some situation. So, there is a need of another parameter for supplementing the gestational age estimation with minimal error. The aim of the study was to evaluate the placental thickness as a parameter for estimation of gestational age and also to assess the growth pattern of placenta with advancing gestational age.Methods: A total of 110 pregnant women who selected randomly from the antenatal clinics (between the gestational ages from 14 weeks to 40 weeks) who did not have any maternal or fetal complications. The biometric parameters: Biparietal Diameter (BPD), Head Circumference (HC), Abdominal Circumference (AC), Femur Length (FL) and the Placental thickness (PT) were measured by ultrasound machine LOGIQ P5 unit with a curvilinear 3.5 MHz transducer. Mean value of the placental thickness along with the standard deviation (SD) and 95% confidence interval were calculated for each gestational age from 14 weeks to 40 weeks. Pearson’s correlation analysis and linear regression analysis was done quantifying the relationship between the gestational age in weeks and the placental thickness in millimetres.Results: The mean values of placental thickness show a perfect positive relationship (increasing trend) with gestational age and the mean value of placental thickness almost correspond to the gestational age till 35 weeks of the gestational age and fall marginally from 36 weeks. Placental thickness showed positive and significant correlation with gestational age (P-value<0.001) and Pearson’s correlation coefficient (r) of 0.990.Conclusions: Placental thickness can be an additional parameter for estimation of the gestational age as it almost corresponds with the gestational age in second and third trimesters. Also, any abnormal placental thickness for the particular gestational age should raise the suspicion of underlying fetal or maternal disease condition which can cause an increased or decreased in the placental thickness and should be addressed in time.


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.


2017 ◽  
Vol 68 (5) ◽  
pp. 1070-1072
Author(s):  
Dan Navolan ◽  
Mirela Nicolov ◽  
Simona Vladareanu ◽  
Ioana Ciohat ◽  
Marius Craina ◽  
...  

Screening of fetal aneuploidies in early pregnancy is a well-established method in the materno-fetal medicine. The aim of our study was to analyze if the medians recommended by the manufacturers are adequate to perform an accurate screening or if there is a need for own laboratory medians calculation in second trimester biochemical marker screening.Sera were collected between 14 wp and 22 wp from 3374 singleton pregnancies. We analyzed three second trimester biochemical markers (AFP, hCG and free Estriol) concentration in all pregnant women and in a subgroup of pregnant women in which gestational age was determined based on crown-rump length. Our results showed that for all biochemical markers the difference between the manufacturer and the own calculated median was lower than 10% excepting the hCG value in the group of pregnant women in which the gestational age was determined on basis of crown-rump-length. Our results show it is recommended to replace the values of the median for hCG measurement with the own laboratory calculated medians. This does not seem to be necessary in the case of AFP and free Estriol measurement.


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.


2020 ◽  
Vol 8 (1) ◽  
pp. 110-113
Author(s):  
Prashanth G Patil ◽  
KM Nataraj ◽  
Shaik Hussain Saheb

Background: Knowledge of gestational age (GA) is important because it affects clinical management in many ways. Ultrasonography has provided a safe and noninvasive means of dating a pregnancy. The purpose of the present study is to assess the relationship of placental thickness with gestational age and to compare it with other sonographic parameters used to estimate gestational age. Subjects and Methods: The study included 242 normal pregnant women who knew their last menstrual period (LMP). After taking consent, all the women underwent an ultrasound examination. During the scan, besides measuring routine biometric parameters, Placental thickness at the cord insertion was also measured. A retrospective study was designated to test the hypothesis that placental thickness in an age dependant variable and hence can predict gestational age. In the end, the predicted gestational age by placental thickness was compared with gestational age as determined by other sonographic parameters. Results: Placental thickness showed a linear progression in relation to the menstrual age. The correlation coefficient was found to be 0.86(p<0.001). The regression equation was formulated by regressing gestational age on the measured placental thickness. The correlation coefficient between GA-LMP and GA-USG was 0.92 as compared to 0.86 between GA-LMP and GA-PT. The standard error for other USG parameters was +2.32 compared to +2.96 for placental thickness. Conclusion: Placental thickness being a fusion of menstrual age, can be used to predict the gestational age by using the regression formula. Gestational age calculated by other USG parameters is closer to menstrual age as compared to that by placental thickness. The prediction interval was slightly more when the placental thickness was used instead of other USG parameters. Placental thickness is a good alternative parameter for predicting gestational age in the second and third trimester.


Author(s):  
Vaibhav Sharma ◽  
Ruchi Saxena ◽  
Priyanka Gaur

Background: Fetal age actually begins at conception and an equivalent term is conceptional age. Uncertain gestational age (GA) has been associated with adverse pregnancy outcomes independent of maternal characteristics. The objective was to evaluate the accuracy of fetal foot length (FFL) in estimation of gestational age.Methods: It was a cross sectional study. Trans abdominal ultrasound on 150 pregnant women with normal singleton pregnancies between 16 to 40 weeks was done to measure FFL. The relationship between GA and FFL was analysed by simple linear regression.Results: A linear relationship was demonstrated between FFL and GA. (GA (in weeks)=7.490+0.393×FFL (in mm)) with significant correlation (r=0.985, p<0.001).Conclusions: Ultrasonographic measurement of FFL is a reliable indicator of gestational age and can be a useful alternative to estimate GA when other routine biometric parameters are not conclusive.


Author(s):  
OJS Admin

Gestational age assessment is one of the most important tool used for estimation of perinatal morbidity and mortality. Age estimation of fetus can be recorded with the help of various parameters such as biparietal diameter, abdominal circumference, head circumference, length of the kidneys, crown rump length, length of the long bones and ossification centers.


2021 ◽  
pp. 64-66
Author(s):  
Sambhunath Bandyopadhyay ◽  
Ritayan Sasmal ◽  
Debarshi Jana

Accurate gestational age determination is very important for management of continuation and termination planning of the pregnancy. rd To establish placental thickness as a parameter for determination of gestational age and fetal growth pattern at 3 trimester. 100 primigravida women who are fullling the inclusion criteria and attend gynae &obs OPD or admitted in their third trimester at IPGME&R from January 2017 to june 2018. Placental thickness at 3rd trimester USG scan is moderately correlated with gestational age, if placental thickness expressed in millimeter then it correlated with gestational age at weeks. rd st Placental thickness with >3.2 cm (32 mm) at 3 trimester almost associated with good fetal outcome, with APGAR score >8 at 1 min and birth weight >2500 gm.


Author(s):  
Priyanka Verma ◽  
Monika Gupta ◽  
Shraddha Verma

Background: Accurate estimation of gestational age and fetal wellbeing is mandatory to ensure safe pregnancy and healthy delivery. With recent development in USG, basic scan, Doppler imaging and interventional radiology helped greatly in accurate estimation of gestational age and delivering timely care. The objectives of this study was to determine the USG placental thickness at the level of insertion of cord in antenatal women from gestational age 11 to 40 weeks. To correlate placental thickness with gestational age. To calculate composite gestational age from USG parameters; CRL, BPD, HC, AC, FL. To compare the relationship of menstrual gestational age with placental thickness and composite gestational age separatelyMethods: It is a comparative study of 2 years duration. Total 322 patients were included. Gestational age was determined from LMP. Patient’s routine obstetric USG was done and composite gestational age was calculated from fetal parameters like BPD, HC, AC and FL (CRL in 11 to 14 weeks). At the same time placental thickness was determined at the level of insertion of umbilical cord. The plane of USG image was adjusted so that the thickness measured from cord insertion is perpendicular to the margin of uterine wall.Results: The following parameters were noted: correlation of period of gestation (weeks) with composite gestational age (weeks) correlation of period of gestation (weeks) with gestational age calculated by placental thickness (weeks).Conclusions: Placental thickness can give an estimation of gestational age. The linear correlation and statistical compatibility of placental thickness makes it an alternate parameter for gestational age. Knowledge of correct gestational age helps in delivering proper antenatal care, assessing fetal wellbeing, identifying pathology at the earliest and timely decision of termination and providing safe motherhood.


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