scholarly journals Fetal Transcerebellar Diameter/ Abdominal Circumference Ratio as a Gestational Age Independent Parameter for Fetal Growth

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   

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):  
Saritha Chinnappan ◽  
Malarvizhi Loganathan

Background: It is important to identify fetal growth restriction (FGR) antenatally because it is associated with increased perinatal morbidity and mortality. There is difficulty in diagnosis of fetal growth restriction using standard ultrasonographic parameters as they are gestational age related and are not reliable in cases of symmetrical growth restriction. Therefore, there is a need for gestational age independent biometric parameter, which can diagnose fetal growth restriction in unknown gestational age and can diagnose both symmetric and asymmetric fetal growth restriction. In this study transverse cerebellar diameter (TCD)/abdominal circumference (AC) ratio used to diagnose fetal growth restriction. Objectives of the study were to evaluate the validity of TCD/AC ratio in diagnosing fetal growth restriction and to find out the cut-off value of TCD/AC ratio for diagnosis of fetal growth restriction.Methods: This study was carried out for 12 months and sample size was 100. Transverse cerebellar diameter, abdominal circumference measured between 20-22wks and 32-34weeks of gestation and transverse cerebellar diameter and abdominal circumference ratio calculated.Results: TCD/AC ratio was fairly constant throughout the pregnancy. Fetuses with TCD/AC ratio more than 2SD of the mean were found growth restricted on examination. The TCD/AC ratio more accurate in diagnosing fetal growth restriction (FGR).Conclusions: As the TCD/AC ratio is constant, it is a gestational age - independent parameter, can diagnose FGR in antenatal women with unknown gestational age. Hence, TCD/AC ratio can be a screening test to diagnose FGR in the antenatal period.


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.


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


2020 ◽  
Vol 7 (8) ◽  
pp. 414-419
Author(s):  
Dr. Abhinaya Arun Raj ◽  
◽  
Dr. K. Maheswari ◽  

Introduction: This study was done to assess the utility of foot length in determining theanthropometric parameters of a newborn in a tertiary care teaching hospital. Materials andMethods: This cross-sectional study among 270 newborns were done at Sri Venkateswaraa medicalcollege hospital and research centre, from Nov 2018 to May 2020. All the healthy live newbornswere taken into the study and newborns with congenital lower limb anomalies were excluded.Results: The mean birth weight of the neonate 2.948+0.344 kg which ranged from 2.050 kg to3.750kg. The mean foot length, head circumference and chest circumference of the foot length was8.113+0.468 cm, 48.989+1.093 cm, 34.437+0.659 cm and 32.372+0.734 cm respectively. The footlength had a maximum correlation with birth weight (r-value=0.905) followed by gestational age (r-value=0.809), length (r-value=0.786), head circumference (r-value=0.719) and chest circumference(r-value=0.603). Conclusion: Foot length had a significant correlation with birth weight andgestational age of the neonates. Foot length also correlated significantly with other anthropometricvariables like length, head circumference and chest circumference.


Author(s):  
Nasim Shirgholami ◽  
Fatemeh Abdi ◽  
Mahta Mazaheri ◽  
Razieh Sadat Tabatabaee

Background: Amniocentesis, like other invasive methods, has complications such as abortion, premature rupture - second pregnancy and at 29 weeks of membranes, infection, bleeding, etc. Here, we aimed to study the complications of amniocentesis in pregnant women. Methods: This descriptive cross-sectional study was included 409 women with positive first and second stage screening or required amniocentesis referred to Baghaeipour Clinic in 2017. Data was collected by a pre-prepared questionnaire. Results: The mean age of the patients and gestational age was 33.49 ± 6.51 years and 17.39 ± 1.36  weeks, respectively. 132 patients (32.2%) had a history of abortion. Regarding the frequency of needle passage through the placenta, the results showed that in 369 people (90.2%) the needle did not pass through the placenta and in 40 people (9.8%). The needle has passed through the pair. Regarding the frequency distribution of amniocentesis complications, fetal death in (2.4%), bleeding in (2.2%) and PROM (1.7%) were observed in patients and no case of infection and abortion was observed. In terms of age, gestational age, gestational number, placental location, needle passage, aspirated fluid color, history of abortion and type of delivery, there were no significant differences. Conclusion: In this study the most common complication of amniocentesis was fetal death (2.4%), followed by bleeding and Spotting (2.2%), PROM (1.7%), infection and abortion, respectively.


2013 ◽  
Vol 26 (2) ◽  
pp. 64-67 ◽  
Author(s):  
Sabrina Q Rashid

Objective: Abdominal circumference measurement is an important parameter for determining  fetal growth. Fetal growth will be more accurately assessed if we use tables constructed on  our own population. A table of fetal gestational age estimation by abdominal circumference in  Bangladeshi population is prepared, so that a quick assessment of its growth can be made.Methods: This study was a prospective, cross-sectional study, conducted on well dated, singleton  pregnancies. A table and a graph were prepared after fitting Polynomial regression models.Results: Nomogram for gestational age estimation by abdominal circumference was prepared.  1223 patients were included in the study. Percentiles, mean and standard deviations were  derived from the raw data. Polynomial regression model was a good fit to the data. Standard  deviations increased with gestational age. In the early second trimester Bangladeshi and  western studies were similar but as pregnancy advanced there was variation between the two  races.Conclusion: This chart can be useful for Bangladeshi population, by helping in assessment of  fetal growth and gestational age by abdominal circumference, especially in the 3rd trimester.  This is so, because abdominal circumference is very sensitive to fetal nutritional status. DOI: http://dx.doi.org/10.3329/bjog.v26i2.13781 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 64-67  


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.


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