Accuracy of Ultrasound to Determine Gestational Age in Third Trimester (original) (raw)
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Evidence Based Women's Health Journal, 2021
Background: Routine sonographic examination is the cornerstone in estimation of gestational age (GA) and management of pregnancy, using Biparietal diameter (BPD), femur length (FL) and Abdominal circumference (AC) ،but there are limitations with using such parameters. fetal cerebellum exhibits a progressive growth throughout the gestation period. So, it is an organ capable of providing information on the prediction of gestational age during the pregnancy this study has evaluated the accuracy of trancerebellar diameter (TCD) over other parameters of gestational age between 30-40 weeks. Aim: The study aims to evaluate the accuracy of TCD in singleton gestation as an accurate parameter compared to other parameters (Fl, BPD, AC) and Hadlock equation in determining gestational age in normal pregnant woman and normal fetus. Materials and Methods: This cross-section study was conducted on 100 pregnant women between 30 to 40 weeks of gestational age who attended the antenatal care in the outpatient clinic at Ain-Shams university maternity hospital in the period from September 2018 to September 2019. The whole patients were fulfilling the inclusion and exclusion criteria and counseled for the study and then ultrasound examination and measurements of the TCD, BPD, FL and AC were recorded, GA by different parameters (TCD, FL, BPD and AC) and GA by Hadlock were compared to GA by last menstrual period (LMP). Results: In our results the TCD was accurate within 1 week in 91% of the cases and was accurate within 3 days in 59% of the cases. While the FL was accurate within 1 week in 82% of the cases and was accurate within 3 days in 51% of the cases. The BPD was accurate within 1 week in 70 % of the cases and within 3 days in 39% of the cases. Finally, the AC was accurate within 1 week in 65 % of the cases and within 3 days in 37% of the cases. Also, GA by TCD and Hadlock equation showed highest correlation with GA by LMP followed by FL and BPD and least accurate was AC. Conclusion: From the study, we can conclude that TCD is the most accurate method for assessment of gestational age in third trimester followed by FL then BPD and the least accurate is the AC. Also, by combining accuracy of TCD (91%) and that of FL (82%) we can be near certain of gestational age in most of our patients even if they are unsure of their dates. Furthermore, TCD and GA by Hadlock equation showed similar accuracy in gestational age assessment. In all methods the accuracy was higher in <35 week than ≥35 week of gestational age. We recommend to conduct this study on larger sample size for further documentation of the proposed assumption.
Bangladesh Medical Journal, 2021
During the gestational period, fetal biometrics are assessed through ultrasonography to observe the growth of the fetus. This study observed the corresponding of gestational age those were measured by two of the fetal diameters; gestational age were calculated from history of last menstrual period (LMP), in the last two trimesters. This descriptive type of observational study was carried out in the Department of Radiology and Imaging of Dhaka Medical College and Hospital, during the period of July, 2004 to June, 2005. Here 291 single-ton, non-complicated pregnant women of LMP were selected purposively from valid record. Bi-parietal diameter (BPD) and femoral length (FL) estimated through ultrasonography. These two parameters compared with the gestational age in second and third trimester. The study found that, before 36th week, the BPD based gestational age varied 2 to 3 days from LMP based gestational age and after that, the variation was 1 to 4 weeks. In case of FL, the ultrasonic...
The Professional Medical Journal
Objective: To compare correct assessment of gestational age betweenTranscerebeller diameter versus femur length in third trimester (28-40) using first day of lastmenstrual period for actual period of gestation. Study Design: Cross-sectional descriptive study.Place and Duration of Study: Department of Obstetrics and Gynecology, Bahawal VictoriaHospital, Bahawalpur from Jun 2012 to Dec 2012. Methodology: This study was performed on327 patients in third trimester of pregnancy from 28-40 weeks fulfilling the inclusion criteria.Ultrasound measurements of transcerebellar diameter (TCD) and femur (FL) were made withcommercially available real time ultrasound equipment Toshiba Nemio-10 model 2009,Transducer frequency 50/60 Hz. Collected data was analyzed by SPSS version 10. Results: Outof 327 patients, TCD was found to give correct assessment corresponding to the gestational ageby LMP in 262 (80.1%) patients, while in 232 (70.9%) patients FL was found to give correctassessment corresponding...
Academia Anatomica International, 2019
Introduction: Precise estimation of gestational age is the key to proper antepartum care. Ultrasonographic estimation of fetal age using various fetal parameters is utilized for accurate estimation because estimation by last menstrual period is not reliable in all cases. Objectives: To assess gestational age with the help of ultrasonographic measurements of fetal biparietal diameter in the local population of the region of Udaipur district of Rajasthan and thereby evaluate significance of this fetal biometric parameter in the prediction of gestational age by ultrasound. Subjects and Methods: Data of Ultrasonographic measurements and patient history was taken from the past records. Statistical analysis: Mean, standard deviation, statistical significance and t test were calculated. Results: The ultrasonographic measurement of biparietal diameter is a reliable indicator of gestational age in second and third trimesters. Conclusion: The derived gestational age is comparable with that used by Hadlock et al.
Ultrasonographic Fetal Gestational Age Determination by Biparietal Diameter
Annals of International medical and Dental Research, 2017
Background: Size and body proportions at birth predict short and long term outcomes. The main determinant of perinatal mortality is low birth weight. Several development indicators like Biparietal diameter (BPD), Head Circumference (HC) and Femur Length (FL) are used to predict the gestational age. Aim: This study was designed to compare the accuracy of predicting gestational age by the measurements of biparietal diameter in the second and third trimester. Methods: This was a cross sectional study of uncomplicated 234 pregnant women of between 17 and 38 weeks of gestation. Results: Biparietal diameter measurements were tabulated against corresponding menstrual age and mean biparietal diameter. Conclusion: Accurate gestational age assessment is also essential in the evaluation of fetal growth and the detection of intrauterine growth restriction.
Background: Assessment of fetal gestational age with ultrasound provides high accuracy and reliability, as ultrasound is safe, easy operating and cheap. Objectives: to predict the GA with BPD and FL, to derive equations from linear regression analysis of GA with BPD and FL this could be applied to determine the fetal GA, to compare between BPD and FL. Methods: there were 100 normal pregnancies (singleton) had been selected for the study during the second and third trimesters. They were scanned with ultrasound using 3.5 MHz probe applying the obstetrics protocol to measure the fetal biometrics. The length of femoral diaphysis was measured from upper end to lower end excluding epiphysis. The biparietal diameter was measured from the fetal skull when being in oval shape; two thalami should be equal in size. The diameter was drawn from inner to outer margins of the skull perpendicular to the thalami. Results: statistical tests such as correlation and linear regression had been used to get the correlation coefficients and linear equations. There was a strong positive correlation between gestational age and femoral length and biparietal diameter (r = 0.97, r = 0.98). The estimation of gestational age from biparietal diameter could be calculated from the equation GA= 3.385+0.359BPD, and the estimation of gestational age could be calculated from the equation GA= 7.890 + 0.388FL. The most accurate most accurate equation to estimate the fetal gestational age was derived from the equation GA= 4.970 +0.157FL+0.218BPD. Conclusion: The estimation of gestational age with fetal biparietal diameter and femoral length still remain the most common measurements to assess the fetal growth. Evaluation of gestational age with biparietal diameter and femoral length joined together is more accurate than biparietal diameter and femoral length when used separately.
IOSR Journals , 2019
Introduction: Knowledge of gestational age is important to the obstetrician because it affects clinical management in many ways. First, this allows obstetrician to anticipate spontaneous delivery and plan delivery for the optimal perinatal outcome. Second, it helps in scheduling invasive procedures and genetic tests. Third, it helps in evaluating fetal growth because normal ranges of parameters change with advancing age. Virtually all important clinical decisions require knowledge of the menstrual age. Materials and Methods: The study was conducted for a period of one and half year from March, 2018 to July, 2019 at the department of obstetrics and gynecology, Santhiram General Hospital, Nandyal.Pregnant mothers presenting either to the outpatient department or in patients with gestational age more than 30 weeks by their LMP. Results: There were 36cases (36%) with gestational age between 30-34wks of gestation, 36cases(36%) between 34-37wks of gestation, 28 cases(28%) between 37-40wks of gestation.In these, there were 15 cases (15%) of pregnancy induced hypertension, 20 cases (20%) of anemia and 5cases (5%) of intrauterine growth restriction.The mean gestational age calculated using LMP ,standard biometric parameters (BPD, HC, AC and FL) and that using kidney length and circumference at 30-34 wks , 34-37 wks and 37-40 wks. Conclusion: Women who present to the obstetrician after 30 weeks who do not recall their LMP's or with unreliable LMP's with no visits or ultrasound examination in early trimesters pose a great problem in assessment of gestational age which is very important in managing the obstetric cases more so high risk pregnancies.
The study was carried out to assess fetal gestational age with the help of ultrasonographic measurements of different fetal biometric parameters [i.e. Biparietal diameter (BPD), Femur length (FL), Abdominal circumference (AC)] and Fetal kidney width ( KW ), in 199 women with singleton uncomplicated pregnancies attending the O.P.D for routine ultrasound fetal biometry in western Uttar Pradesh (UP). Above fetal parameters were measured biweekly, between 18 and 38 weeks of gestation. Linear regression models for estimation of gestational age were derived from above fetal biometric parameters. The linear regression model for estimating fetal gestational age is femur length, abdominal circumference, fetal kidney width and biparietal diameter in that order with standard error of ± 3.85, ± 4.85, ± 5.81 and ± 8.75 days respectively. Key words: Gestational age, Biparietal diameter, Femur length, Abdominal circumference and fetal kidney width
Accuracy of emergency physicians using ultrasound to determine gestational age in pregnant women
The American Journal of Emergency Medicine, 2010
Introduction: Rapid and accurate determination of gestational age may be vital to the appropriate care of the critically ill pregnant patient. Before the use of emergency ultrasound, physical examination of fundal height (FH) in the nonverbal patient was considered the quickest method to estimate gestational age. We conducted a prospective, observational study of the performance of bedside sonography to determine gestational age. Methods: We enrolled a convenience sample of women in their second or third trimester of pregnancy. Emergency physicians (EPs) made ultrasound measurements of fetal biparietal diameter (BPD) and femur length, followed by a measurement of FH. These measurements were compared with true gestational age (TGA), sonography by an ultrasound technician, and measurement of FH performed by an obstetrician. Main outcome measures were the average time needed to complete measurements; correlation coefficients between EP measurements and those made by an ultrasound technician, an obstetrician, and TGA, and overall accuracy to determine fetal age greater than 24 weeks. Results: The average time to complete ultrasound measurements was less than 1 minute. When physician-performed measurements were compared with TGA, the correlation coefficients were 0.947 (0.926-0.968) for BPD, 0.957 (0.941-0.973) for femur length, and 0.712 (0.615-0.809) for FH. When determining fetal viability, EP's overall accuracy was 96% using ultrasound and 80% using FH. Conclusions: With brief training, EPs can quickly and accurately determine gestational age using ultrasound, and these estimates may be more accurate than those obtained through physical examination. Emergency physicians should consider using ultrasound in emergent evaluation of pregnant patients who are unable to provide history.