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 TO COMPARE ESTIMATION OF GESTATIONAL AGE BY FOETAL TRANSCEREBELLAR DIAMETER WITH BIPARIETAL DIAMETER`, FEMUR LENGTH, ABDOMINAL CIRCUMFERENCE, HEAD CIRCUMFERENCE AT DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY AT SMS MEDICAL COLLEGE, JAIPUR

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Samta Solanki ◽  
Anusha S ◽  
B S Meena
Keyword(s):  
Gestational Age ◽  
Cross Sectional Study ◽  
Abdominal Circumference ◽  
Third Trimester ◽  
Cross Sectional ◽  
Femur Length ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Biparietal Diameter ◽  
The Mean

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

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 The Role of Fetal Kidney Length and Fetal Transverse Diameter of Heart in Prediction of Gestational Age

2020 ◽  
Vol 5 (04) ◽  
Author(s):  
Panda Subrat ◽  
Rudrapal Gouri Sankar ◽  
Das Ananya ◽  
Ray Baruah Surajit ◽  
Sharma Nalini
Keyword(s):  
Gestational Age ◽  
First Trimester ◽  
Accurate Estimation ◽  
Transverse Diameter ◽  
Second Trimester ◽  
Fetal Kidney ◽  
Third Trimester ◽  
Kidney Length ◽  
Singleton Pregnancies

Objective: Currently there is no single ultrasonological parameter for accurate estimation of gestational age in third trimester. The present study is undertaken to validate the fetal kidney length and fetal transverse diameter of heart measurement as a measurement of fetal growth with less variability. Materials & Methods: It is a cohort study conducted in Department of Obstetrics and Gynaecology, NEIGRIHMS from 2015 to 2016. 224 women with singleton pregnancies and sure of LMP were enrolled. Each woman underwent minimum three ultrasonographic measurements- at first trimester for gestational age by CRL, at second trimester with fetal conventional biometry, at third trimester with Fetal kidney length, transverse diameter of heart and fetal conventional biometric parameters and analysed with SPSS Version22. Results: The gestational age with CRL was within three days of the menstrual age. In second trimester, conventional parameter (BPD,HC,AC,FL) were better parameters. Conventional parameter did not correspond to gestational age calculated from LMP. (BPD, R2= 0.4819, HC R2- 0.507, AC R2- 0.5175, FL R2-0.5243, Combined Conventional parameter R2- 0.5888). Fetal kidney length (R2-0.8356) and transverse diameter of heart (R2-0.8795) better correlated with gestational age. Conclusion: Kidney length and transverse diameter of heart are better predictors of gestational age in third trimester.

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

2018 ◽  
Vol 7 (11) ◽  
pp. 4619
Author(s):  
Dipali Kadam ◽  
Saurabh Patil ◽  
Meenal Jain
Keyword(s):  
Gestational Age ◽  
Abdominal Circumference ◽  
P Value ◽  
Third Trimester ◽  
Cross Sectional ◽  
Femur Length ◽  
Biparietal Diameter ◽  
Antenatal Sonography ◽  
Umbilical Cord Insertion ◽  
Placental Thickness

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.

scholarly journals Estimation of gestational age using foetal kidney length during second and third trimester in south Indian population

Biomedicine ◽  
2021 ◽  
Vol 40 (4) ◽  
pp. 436-441
Author(s):  
Kalpana Ramachandran ◽  
Arunthathy Gnaneshwar ◽  
Robert Dinesh Kumar ◽  
Parvathavarthine CR ◽  
Sri Santhana Krishnan V
Keyword(s):  
Gestational Age ◽  
Tertiary Care ◽  
Abdominal Circumference ◽  
South Indian Population ◽  
Strong Positive Correlation ◽  
Third Trimester ◽  
Age Assessment ◽  
South Indian ◽  
Kidney Length ◽  
Foetal Kidney

Introduction and Aim: Gestational age assessment in women with indeterminate last menstrual period has always remained an enigma. Though multiple parameters have been found useful in providing an indirect age assessment, various studies have now shown that the ultrasonographic measurement of foetal kidney length during the second and third trimester of pregnancy is a viable alternative in foetal age assessment. Methods: This prospective study was conducted among the antenatal women with singleton uncomplicated pregnancy during 18 to 40 weeks of gestation attending the outpatient department for routine ultrasound foetal biometry in a tertiary care referral institution in South India, during January 2019 to June 2019. A total of hundred and thirty-five antenatal mothers were included in this study. Data entry was done in Microsoft Excel and data analysis was done using Statistical Package for Social Sciences (SPSS). Results: There was a strong positive correlation between GA and MKL. Regression model (Model 1) for Mean kidney length showed significant correlation and regression models (Model 2) for MKL and routine foetal biometric parameters like biparietal diameter, femur length and abdominal circumference were found to be significantly correlated. Conclusion: Mean foetal kidney length can alone predict gestational age and by combining it with the other biometric indices to give a better estimation of gestational age.

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 FETAL TRANSVERSE CEREBELLAR DIAMETER MEASUREMENT;

2018 ◽  
Vol 21 (05) ◽  
pp. 888-891
Author(s):  
Anjum Afshan ◽  
Shabnam Nadeem ◽  
Shabnam Shamim Asim
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Normal Growth ◽  
Maternity Hospital ◽  
Accurate Estimation ◽  
P Value ◽  
Diameter Measurement ◽  
Third Trimester ◽  
The Third ◽  
The Mean

Objective: To determine the accuracy of fetal transverse cerebellar diametermeasurement in the prediction of gestational age in growth restricted fetuses. Material andmethods: This controlled was conducted at Sobhraj Maternity Hospital, Karachi from July 2012to June 2013. A total of 100 pregnant women in the third trimester of pregnancy satisfying theeligibility criteria were included. Among these 50 were fetuses with normal fetal growth and50 growth restricted fetuses. Results: The mean transverse cerebellar diameter in the fetusesshowing normal growth was not statistically different from the mean transverse cerebellardiameter in the growth restricted fetuses (p-value = 0.219). Conclusions: Transverse cerebellardiameter measurement can be used reliably for accurate estimation of gestational age in growthrestricted fetuses.

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