scholarly journals Impact of Placenta Previa on Fetal Growth

2021 ◽  
pp. 54-63
Author(s):  
Hassan Abubakr Elrewany ◽  
Mohamed Mohsen El Namori ◽  
Shahinaz Hamdy Elshourbagy ◽  
Ahmed Mahmoud Awarah
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Placenta Previa ◽  
Cerebral Arteries ◽  
Vital Signs ◽  
Placental Tissue ◽  
Mean Value ◽  
Abdominal Circumference ◽  
Cross Sectional ◽  
Femur Length

Background: Placenta Previa refers to the presence of placental tissue that extends over the internal cervical is during pregnancy. The incidence of this condition is reported to be 2% at 20 weeks of gestation and decreases to around 4–6 per 1000 births between 34 and 39 weeks through trophotropism. The aim of the work is to evaluate fetal growth in pregnancies complicated by placenta Previa. Methods: This cross-sectional study was done on 100 pregnant females with placenta Previa aged 18-35 years. Cases were defined as patients with gestational age 24-40 weeks, BMI 18-30 kg/m2, Singleton fetus and diagnosed having placenta Previa; confirmed by trans-vaginal ultrasound in the second and third trimester. Complete history, vital signs and complete obstetric examination, laboratory and radiological investigations (ultrasound done trans-abdominally to evaluate fetal weight, biometry and Doppler studies) were taken. Results: The gestational age ranged from 34-39 weeks with a mean value 36.03 ± 1.23 weeks and a median value 36 weeks (IQR = 35-37 weeks). The femur length ranged from 33.14-39.14 weeks with a mean value 35.44 ± 1.56 weeks and a median value 35.14 weeks (IQR = 34-36.9 weeks).The abdominal circumference ranged from 32.86-39.14 weeks with a mean value 35.43 ± 1.65 weeks with a median value 35.14 weeks (IQR = 33.9-36.7 weeks). As regard to umbilical (UA) and middle cerebral (MCA) arteries Doppler resistant index (RI), UA ranged from 0.48-0.58 with a mean value 0.53 ± 0.03 and a median value 0.53 (IQR = 0.51-0.55). MCA ranged from 0.75-0.85 with a mean value 0.80 ± 0.03 and a median value 0.79 (IQR = 0.77-0.82). Conclusion: Placenta Previa led to preterm delivery (<36 weeks) in about one third of the study cases. Femur length was <36 weeks in 65 patients. Abdominal circumference was <36 weeks in 61 patients. Placenta Previa had insignificant effect on umbilical (UA) and middle cerebral arteries Doppler resistant index.

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 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 Transverse cerebellar diameter: a reliable predictor of gestational age

2020 ◽  
Vol 20 (4) ◽  
pp. 1927-32
Author(s):  
Sanjay Mishra ◽  
Surajit Ghatak ◽  
Pratibha Singh ◽  
Dushyant Agrawal ◽  
Pawan Garg
Keyword(s):  
Gestational Age ◽  
Indian Population ◽  
Cross Sectional Study ◽  
Abdominal Circumference ◽  
Sectional Study ◽  
Ethnic Population ◽  
Cross Sectional ◽  
Femur Length ◽  
Biparietal Diameter ◽  
Significant Difference

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.

scholarly journals Can trans-cerebellar diameter supersede other fetal biometry in measuring gestational age? A prospective study

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Rintu George ◽  
Umamageswari Amirthalingam ◽  
Mohamed Rafi Kathar Hussain ◽  
Vigneshwar Aditiya ◽  
A. M. Anand ◽  
...  
Keyword(s):  
Gestational Age ◽  
Abdominal Circumference ◽  
Radiology Department ◽  
Fetal Head ◽  
Cross Sectional ◽  
Femur Length ◽  
Fetal Biometry ◽  
Biparietal Diameter ◽  
A Prospective Study ◽  
Gestational Age Estimation

Abstract Background Estimation of gestational age plays a pivotal role in day to day clinical practice for appropriate management of newborn. The trans-cerebellar diameter can predict gestational age in cases of variations of fetal head shape such as dolichocephaly and brachycephaly or even when fetus is in posterior position. Trans-cerebellar diameter (TCD) may be useful in gestational age estimation. Aim and methodology To determine the accuracy of trans-cerebellar diameter in the estimation of gestational age of fetus and comparing the conventional parameters like head circumference, biparietal diameter, abdominal circumference and femur length in the measurement of gestational age. This is a prospective, cross-sectional analytical study done in the Radiology Department in those patients who were referred to the department for a routine antenatal ultra-sonogram checkup. Results Comparison of trans-cerebellar diameter with gestational age derived from last menstrual period indicates that there is a linear relationship throughout the gestational ages. There is a strong correlation of trans-cerebellar diameter with other conventional parameters namely biparietal diameter, femur length and abdominal circumference of which Femur length correlates well with the trans-cerebellar diameter. Correlation of transcerebellar diameter with gestational age shows a R2 of 0.995 (p value < 0.001). Conclusion Trans-cerebellar diameter is best in estimation of gestational age when compared to biparietal diameter, femur length and abdominal circumference. The regression formula derived from trans-cerebellar diameter measurement can be applied to determine the gestational age of fetus.

scholarly journals Gestational age Estimated by Abdominal Circumference in Bangladesh

2013 ◽  
Vol 26 (2) ◽  
pp. 64-67 ◽  
Author(s):  
Sabrina Q Rashid
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Age Estimation ◽  
Polynomial Regression ◽  
Cross Sectional Study ◽  
Abdominal Circumference ◽  
Cross Sectional ◽  
Standard Deviations ◽  
Bangladeshi Population ◽  
Gestational Age Estimation

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  

scholarly journals Placental Thickness and Its Correlation with Gestational Age: A Cross-sectional Ultrasonographic Study

2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Sumnima Acharya ◽  
Awadesh Tiwari ◽  
Rupesh Sharma
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Growth Parameters ◽  
Pearson Correlation ◽  
Abdominal Circumference ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Reliable Parameter ◽  
The Difference ◽  
Placental Thickness

Introduction: Placenta grows in size with the advancement of gestational age (GA) and plays an important role for delivery of nutrients from mother to fetus. Ultrasonography (USG) is implicated for the estimation of GA by using fetal growth parameters like Femur Length (FL), Bi-parietal Diameter (BPD), Head Circumference (HC), and Abdominal Circumference (AC). This study intends to observe the correlation between Placental Thickness (PT) and GA. Methods: It was an observational, cross-sectional, and analytical study conducted over a period of six months from November 2017 to April 2018. Fetal growth parameters i.e. FL, BPD, HC, and AC were measured to estimate GA. PT was also measured at the same time. Results: There was a positive correlation between PT and GA (r = 0.89, n=249, p < 0.001). Pearson correlation coefficient between the two variables at second and third trimesters were 0.81 and 0.49 respectively. Fisher r-to-z transformation was used to analyze the difference between those two coefficients and was found to be statistically significant (z = 4.6, p < 0.001). This indicates that there was a significant overall relationship between PT and GA. As GA increases, PT also increases. Conclusion: Our study observed a positive correlation between the PT and GA in second and third trimesters. Thickness of placenta can thus be used as a reliable parameter for the estimation of GA during the second and third trimesters, and can be used as a supplementary USG parameter along with FL, BPD, HC and AC.

scholarly journals Determination of Gestational Age: A Perspective With the Bangladeshi Ethnicity

2018 ◽  
Vol 14 (6) ◽  
pp. 375
Author(s):  
M. Lutfor Rahman ◽  
Aysha Sultana ◽  
Kalyan Das
Keyword(s):  
Gestational Age ◽  
Regression Models ◽  
Abdominal Circumference ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Anatomical Structures ◽  
Femur Length ◽  
Precise Estimation ◽  
Biparietal Diameter

Determination of gestational age (GA) with precision is vital to the proper care of pregnant mothers. Our present study aimed at determining the gestational ages by the ultrasonic measurements of four standard fetal parameters namely biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) specifically focusing on the Bangladeshi ethnic population. The current study is cross-sectional but data were collected in a prospective nature. There were 229 Bangladeshi women who had usual singleton fetuses with the evidence of menstrual dates by sonography before 14 weeks. Fetal anatomical structures have been scanned and measured at the time of sonographic inspection. Multiple linear regression models of GA by the date of last menstrual period (LMP) and GA by ultrasonographic measures have been fitted on four fetal parameters for our analysis. In the present analysis, we have found that all the response variables i.e. gestational age by LMP and gestational age by ultrasonography (USG) clearly depend on the fetal parameters. The best subsets regression analysis shows that BPD, AC, and FL are the best predictors of GA by LMP (adj R 2 = 96.54). In terms of Mallow’s Cp and adj R 2 , it is found that all the fetal parameters BPD, AC, HC and FL are important predictors for GA by USG. It has been observed that multiple fetal parameters measured by ultrasonography can be useful to predict gestational age during second and third trimesters. Precise estimation of gestational age by this method is helpful to reduce pregnancy-related complicacy and maternal death in the developing countries including Bangladesh.

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
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Abdominal Circumference ◽  
Independent Parameter ◽  
Sectional Study ◽  
Cross Sectional ◽  
Biparietal Diameter ◽  
The Mean ◽  
Age Independent

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   

scholarly journals Investigating the Relationship Between Ultrasound Criteria in Determining the Age of Postdate Pregnancy

2021 ◽  
Author(s):  
Nazanin Farshchian ◽  
Ali Naghdian ◽  
Parisa Bahrami Kamangar
Keyword(s):  
Gestational Age ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Abdominal Circumference ◽  
Cross Sectional ◽  
Femur Length ◽  
Biparietal Diameter ◽  
The Relationship ◽  
Correlation Rate ◽  
First Trimester Ultrasound

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.

scholarly journals A cross-sectional study to evaluate sonographic foetal humerus length for estimation of gestational age in normal singleton pregnancies at a tertiary care centre

2019 ◽  
Vol 8 (9) ◽  
pp. 3622
Author(s):  
Premlata Mital ◽  
Richa Ainani ◽  
Nupur Hooja ◽  
Priya Sonkhya ◽  
Vishwas Pradodh ◽  
...  
Keyword(s):  
Gestational Age ◽  
Head Circumference ◽  
Cross Sectional Study ◽  
Abdominal Circumference ◽  
Additional Parameter ◽  
Sectional Study ◽  
Cross Sectional ◽  
Femur Length ◽  
Biparietal Diameter ◽  
Singleton Pregnancies

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.

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