Correlation between Fetal Kidney Length and Fetal Biometry for Gestational Age Determination in Third Trimester in Low-risk Pregnancy

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.

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Effectiveness of Routine Third Trimester Ultrasonography to Reduce Adverse Perinatal Outcomes in Low-risk Pregnancy (the IRIS Study): Nationwide, Pragmatic, Multicentre, Stepped Wedge Cluster Randomized Trial

Obstetric Anesthesia Digest ◽

10.1097/01.aoa.0000719604.55319.7b ◽

2020 ◽

Vol 40 (4) ◽

pp. 206-207

Author(s):

J. Henrichs ◽

V. Verfaille ◽

P. Jellema ◽

L. Viester ◽

E. Pajkrt ◽

...

Keyword(s):

Randomized Trial ◽

Perinatal Outcomes ◽

Cluster Randomized Trial ◽

Low Risk ◽

Stepped Wedge ◽

Third Trimester ◽

Risk Pregnancy ◽

Low Risk Pregnancy ◽

Adverse Perinatal Outcomes ◽

Cluster Randomized

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A Randomized Controlled Study to assess the Role of Routine Third Trimester Ultrasound in Low-risk Pregnancy on Antenatal Interventions and Perinatal Outcome

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1292 ◽

2014 ◽

Vol 6 (3) ◽

pp. 139-143 ◽

Cited By ~ 1

Author(s):

Hema Dhumale ◽

Yeshita Pujar ◽

Komal Gurunath Revankar

Keyword(s):

High Risk ◽

Perinatal Outcome ◽

Low Risk ◽

Controlled Study ◽

Third Trimester ◽

Randomized Controlled ◽

Risk Pregnancy ◽

Low Risk Pregnancy ◽

And Control

ABSTRACT Objective To assess the role of routine third trimester ultrasound in low-risk pregnancy on antenatal interventions and perinatal outcome. Design Randomized controlled study. Setting KLES Dr Prabhakar Kore Hospital and Medical Research Center, Belgaum. Subjects A total of 290 low-risk pregnant women between 34 and 37 weeks attending antenatal clinic and fulfilling inclusion criteria were allotted using computer-generated randomization numbers into study and control groups. Intervention In study group, third trimester ultrasound was performed to assess fetal growth, amniotic fluid index (AFI), malpresentations, and late onset fetal anomalies. In control group, no routine ultrasound was performed, unless indicated by clinical suspicion during subsequent visits. High-risk fetuses identified were managed as per the standard protocol. All women were followed to assess antenatal interventions, intrapartum events and perinatal outcome. Results Detection of high-risk fetuses antenatally in study and control groups was 17.25 and 2.07% respectively. This difference was statistically significant (p = —0.0001). Rates of antenatal interventions among study and control were 24.8 and 4.44% respectively. Prevalence of small for gestational age (SGA) fetuses among study and control was 6.9 vs 11.03% respectively. This difference was not statistically significant (p = —0.253). There was no statistical difference in adverse intrapartum events, cesarean section rate for nonreassuring cardiotocography (CTG), low Apgar score and neonatal intensive care unit (NICU) admissions among study and controls. Conclusion Routine third trimester ultrasound is a logical solution for detection of high-risk fetuses in low-risk pregnancies which would otherwise be missed by clinical examination. However, this leads to an increase in antenatal interventions without significantly influencing the perinatal outcome. How to cite this article Revankar KG, Dhumale H, Pujar Y. A Randomized Controlled Study to assess the Role of Routine Third Trimester Ultrasound in Low-risk Pregnancy on Antenatal Interventions and Perinatal Outcome. J South Asian Feder Obst Gynae 2014;6(3):139-143.

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Routine third trimester ultrasound in low risk pregnancy confers no benefit!: FOR : The benefits of routine third‐trimester scanning are less clear cut

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.13941 ◽

2016 ◽

Vol 123 (7) ◽

pp. 1121-1121 ◽

Cited By ~ 2

Author(s):

J Thornton

Keyword(s):

Low Risk ◽

Third Trimester ◽

Clear Cut ◽

Risk Pregnancy ◽

Low Risk Pregnancy

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

Women Health Care and Issues ◽

10.31579/2642-9756/036 ◽

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.

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Sonographic Correlation of Gestational Age with Fetal Kidney Length

International Journal of Infertility & Fetal Medicine ◽

10.5005/jp-journals-10016-1125 ◽

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.

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