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

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.

2020 ◽  
Vol 3 (4) ◽  
pp. 01-09
Author(s):  
Amal S. Zaghloul

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.


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.


2018 ◽  
Vol 6 (3) ◽  
pp. 159-165
Author(s):  
Dr Alexander George ◽  
◽  
Dr Reena Alexander ◽  
Dr Solomon T Abraham ◽  
Dr Rhutu Venugopal E V. ◽  
...  

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.


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.


2016 ◽  
Vol 150 (4) ◽  
pp. S1115
Author(s):  
Chandasekar S. Thoguluva ◽  
Viveksandeep C. Thogulva ◽  
Gokul J. Bollu ◽  
Sathiamoorthy Suriyanarayanan ◽  
Raja Yogesh Kalamegam ◽  
...  

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


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