scholarly journals Fetal Foot Length and Its Sonographic Correlation with Gestational Age

Author(s):  
Sandhya Hemraj ◽  
Devdas K Acharya ◽  
Sally M Abraham ◽  
US Vinayaka ◽  
G Ravichandra

ABSTRACT Introduction Accurate assessment of gestational age and fetal growth using ultrasound is imperative in providing good quality antenatal and perinatal care. It provides a noninvasive reliable estimate of the gestational age and serves as a baseline upon which interval fetal growth can be assessed throughout pregnancy. Aim The present study was undertaken to assess the relationship between gestational age and fetal foot length and to derive a nomogram correlating gestational age in weeks with fetal foot length. Materials and methods This was a prospective, cross-sectional study conducted on 300 pregnant women between 18 and 39 weeks of gestation after obtaining their written informed consent. Our inclusion criteria were women with singleton pregnancies who were certain of their last menstrual periods; who had previous regular menstrual cycles; who had undergone a fi rst trimester dating scan; who had a normal anomaly scan; and with normal amniotic fl uid volume. Each patient underwent a detailed antenatal ultrasound study in which, in addition to routine fetal biometry, each fetal foot length was measured. In each fetus, the measurements of the two feet were averaged for analytical purpose. For each gestational age, the fetal foot length was calculated from the raw data and linear regression analysis was used to establish a relationship between sonographic gestational age and fetal foot length. The p value was also calculated to estimate the level of signifi cance. Results Our study demonstrated a strong statistically significant linear relationship between gestational age and fetal foot length during the second and third trimesters of gestation. How to cite this article Hemraj S, Acharya DK, Abraham SM, Vinayaka US, Ravichandra G. Fetal Foot Length and Its Sonographic Correlation with Gestational Age. Donald School J Ultrasound Obstet Gynecol 2017;11(2):141-145. Confl ict of interest: None

2020 ◽  
Vol 7 (6) ◽  
pp. 1319
Author(s):  
Ajay K. Keshwani ◽  
Swati S. Suroshe

Background: India contributes to one fifth of global live births and more than a quarter of neonatal deaths. A systematic analysis of global, regional and national causes of child mortality in 2013 identified preterm birth complications and infections to be the two major causes of neonatal deaths in India. So, there is need of a simple, easy to use and reliable screening tool for assessment of gestational age at peripheral level for early referral of a neonate to a tertiary care hospital, thereby reducing neonatal mortality.Methods: A hospital based observational cross-sectional study included 350 live new-borns within 48 hours of birth, from September 2018 to February 2019. Gestational age assessed by new ballard score, birth weight, foot length and right nipple to umbilicus distance were noted. Babies categorised as per the gestational age profile as small, appropriate and large for gestational age using fenton charts. Data analysis done, correlation coefficient, and p value calculated to obtain results.Results: Out of 350 babies, males (185) outnumbered females (165); 154 were LBW, 89 VLBW and 76 were ELBW. AGA neonates were 193, and 157 belonged to SGA. There were no post-term and large for gestational age newborns. Both foot length and right nipple to umbilicus distance correlated well with gestational age in all age groups (p<0.001).Conclusions: Foot length as well as right nipple to umbilicus distance can be used as a reliable tool for assessment of gestational age and birth weight of newborns by any health care professional to identify and refer high risk neonate.


2016 ◽  
Vol 7 (2) ◽  
pp. 37-41
Author(s):  
Sandhya Hemraj ◽  
Sally M Abraham ◽  
US Vinayaka ◽  
G Ravichandra ◽  
Devdas Acharya

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.


2020 ◽  
Vol 7 (9) ◽  
pp. 1889
Author(s):  
Omprakash S. Shukla ◽  
Jagruti J. Rathva

Background: Gestational age is a major determinant of newborn prognosis. Early identification of gestational age is a major priority to reduce global mortality from preterm birth. Therefore this study was conducted with an aim to find out an alternate simple, low cost and reliable method to identify accurate gestational ages.Methods: The cross sectional study was carried out at Rukmani Chainani Maternity and Neonatal Unit, SSGH and Medical College, Baroda from December 2019 to May 2020. Total 500 live newborns of different gestational ages within 72 hrs of birth which were appropriate for gestational age were enrolled in this study. Foot length, head circumference, crown heel length and weight were measured. Gestational age was estimated by antenatal USG, Ballard scoring and LMP. Correlation of foot length to gestational age and other anthropometric variables was done.Results: There was statistically significant positive correlation found between foot length and gestational age (correlation coefficient of 0.944 and p value of <0.0001). There was also positive correlation found between foot length and weight, head circumference and length with correlation coefficient of 0.942, 0.888 and 0.906, respectively. Using ROC curve, foot length cut-off value of 7.2 cm can be used for identifying preterm babies with sensitivity of 94.4% and specificity of 95.6%. Regression equation for gestational age calculation was GA=6.669+4.0601[FL].Conclusions: This study had demonstrated that Foot length is a simple and reliable anthropometric measurement to assess gestational age and to screen prematurity. 


Author(s):  
Rubiyati Rubiyati

ABSTRACT Antenatal Care is the care given to pregnant woman to monitor, support maternal health and maternal detect, whether normal or troubled pregnant women. Aki in Indonesia amounted to 359 in 100.000 live births. The purpose of the study was to determine the relationship between age and education in the clinic Budi Mulia Medika 2014. This study used a survey method whit cross sectional analytic. This is the overall study population of women with gestational age ≥36 weeks who come to visit the clinic Budi Mulia Medika Palembang on February 10 to 18. The study sample was taken in non-random with the technique of “accidental smapling “ with respondents who happens to be there or variable. The obtained using univariate and bivariate analysis using Chi-Square test statistic. The results of the univariate analysis showed that 83,3% of respondents did according to the standard prenatal care, high risk age 40,0 %, 60,0% lower risk of age, higher education 70,0%, 30,0% low education. Bivariate analysis showed that there was no significant relationship betwee age and pregnancy tests wit p value= 0,622, and significant relationship between education and prenatal care with p value= 0,019. From the results of this study are expected to need to increase outreach activities to the community about the importance of examination of pregnancy according to gestational age in an effort to reduse maternal mortality.   ABSTRAK Antenatal Care merupakan pelayanan  yang di berikan pada ibu hamil untuk memonitor, mendukung kesehatan ibu dan mendeteksi ibu, apakah ibu hamil normal atau bermasalah. Di Indonesia AKI berjumlah 359 per 100.000 kelahiran hidup. Tujuan penelitian adalah untuk mengetahui hubungan antara usia dan pendidikan dengan pemeriksaan kehamilan di klinik budi mulia medika tahun 2014. Penelitian ini menggunakan metode survey analitik dengan pendekatan cross sectional. Populasi penelitian ini adalahseluruh ibu dengan usia kehamilan ≥ 36 minggu yang dating berkunjung ke Klinik Budi Mulia Medika pada tanggal 10-18 Februari. Sampel penelitian ini di ambil secara non random dengan tekhnik ‘’ Accidental Sampling’’ dengan responden yang kebetulan ada atau tersedia. Data yang di peroleh menggunakan analisis univariat dan bivariat menggunakan uji statistik Chi-Square. Hasil analisis univariat ini menunjukan bahwa 83,8% responden melakukan pemeriksaan kehamilan sesuai standar, 16,7% tidak melakukan pemeriksaan kehamilan sesuai standar, usia resiko tinggi 40,0%, usia resiko rendah 60,0%, pendidikan tinggi 70,0 %, pendidikan rendah 30,0 %. Analisis bivariat menunjukan bahwa tidak ada hubungan bermakna antara usia dengan pemeriksaan kehamilan dengan p value =0,622, ada hubunngan bermakana antara pendidikan dengan pemeriksaan kehamilan dengan p value = 0,019. Dari hasil penelitian ini di harapkan perlu meningkatkan kegiatan penyuluhan kepada masyarakat tentang pentingnya dilakukan pemeriksaan kehamilan sesuai dengan umur kehamilan sebagai upaya menurunkan angka kematian ibu.    


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.


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.


2020 ◽  
Vol 7 ◽  
pp. 2333794X2097420
Author(s):  
Shiyam Sunder Tikmani ◽  
Sana Roujani ◽  
Syed Iqbal Azam ◽  
Haleema Yasmin ◽  
Khadija Bano ◽  
...  

Preterm births have a high risk of mortality. Therefore, knowledge of the gestational age (GA) at birth is crucial to guide the appropriate management of a newborn. Common methods for estimating GA such as the last menstrual period, ultrasonography, and post-natal Ballard scoring have some limitations. This study aimed to determine the relationship between foot length and GA to develop and validate an equation for predicting GA of Pakistani newborns. We conducted a prospective study in a large obstetric hospital in Pakistan. Data for this analysis were extracted from the hospital files of eligible women by trained study midwives. Midwives were also trained in performing the Ballard examination and taking foot length using a disposable measuring tape within an hour of the birth. The GA was calculated using an android-based GA calculator. Simple and multiple linear regression were used to construct predicting equations for GA. Both the foot length and GA were available for 1542 cases. The median GA was 34.5 (IQR 4.7) weeks and the median foot length was 7 cm (IQR 1.4). There was a positive linear relationship between foot length and GA ( r2 81.7%, P-value < .001). Stratified analysis showed an r2 of 81.7% for males and 81.6% for females. The r2 for stillbirths was 84.1% and, 82.3% for live births. The r2 for macerated stillbirths was 88.6% and 90.6% for fresh stillbirths. In resource poor settings, the use of foot length can estimate GA in both live births and stillbirths and can easily identify preterm infants.


2020 ◽  
Vol 8 (3) ◽  
pp. 131-135
Author(s):  
Muna Badu ◽  
Shankar Bahadur Singh Rajbhandari ◽  
Pashupati Regmi

Background: Gestational age and fetal weight estimation by ultrasound is the most effective and accurate method to date pregnancy. Ultrasound has been used to characterize placental position and morphologic changes. Placental thickness could be one additional parameter to assess gestational age and fetal weight. Objectives: This study aims to investigate the relationship between placental thickness with gestational age and fetal weight in third trimester of pregnancy in primigravida. Methodology: Prospective hospital based cross sectional study was conducted including 111 primigravida in third trimester with normal singleton pregnancies in Department of Radiology of Kathmandu Medical College Teaching Hospital from November 2018 to February 2019. Patients with known medical and obstetrical complications were excluded from the study. Placental thickness in millimeters was measured at the level of insertion of the umbilical cord. Pearson’s correlation analysis was used for analyzing variables and p-value <0.05 was considered statistically significant. Results: Mean age of participants was 28.3 ± 4.79 years. Posterior location of the placenta was most common (35%). Placental thickness correlated well with the gestational age and fetal weight. Pearson correlation coefficient was found to be 0.645 for placental thickness with gestational age and 0.598 for placental thickness with fetal weight. P-value was <0.001 in both, showing positive correlation of mentioned variables with placental thickness. Conclusion: Placental thickness can be a new and reliable parameter for estimation of gestational age and fetal weight. It can be routinely used during antenatal checkup.


Author(s):  
Monalisa Peter ◽  
Ajit Kumar Nayak ◽  
Prajna Paramita Giri ◽  
Manju Kumari Jain

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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