Fetal foot length for assessment of gestational age: a cross sectional study
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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.Keywords:
Cross-sectional study
Foot (prosody)
A case of twin pregnancy with congenital malformations and intrauterine death of one fetus in the 27th week of pregnancy has been discussed. The pregnancy was continued with special care of the mother and the alive fetus. During all stay of the pregnant in the clinic no coagulation disturbances were observed. In the 33rd week of pregnancy spontaneous labour occurred, which was conducted by vaginal delivery. Simultaneously a macerated dead fetus and an alive premature newborn were born. The alive one was charged home in good condition in the 38th day of staying in the Neonatal Ward.
Twin Pregnancy
Intrauterine death
Fetal death
Neonatal death
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Position (finance)
Ultrasound imaging
Early pregnancy factor
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To investigate and evaluate the pregnancy outcomes and fetal loss after fetal reduction of triplets to twins or singleton pregnancy.282 cases of triplets who received multi-fetal pregnancy reduction (MFPR) at Shandong Provincial Hospital affiliated to Shandong University were recruited from Sep 2001 to Mar 2014. According to the remaining fetal number after MFPR, 231 cases were opted to reduce to twins (twins group) while 51 cases were opted to singleton pregnancy (singleton group). The indication of the former group was fetal abnormalities under ultrasound or on patients' demand; while the indication for the later group included dichorionic triamniotic (DCTA) triplets or patients' aspiration. Potassium chloride was injected into the targeted fetal heart until cardiac standstill was obtained. The pregnancy outcomes, gestational age at delivery, birth weight of newborns of the two groups were recorded. Successful pregnancy was defined as take-home at least one baby.(1) The overall rate of successful pregnancy was 91.5% (258/282). There were 413 neonates in the twins group, including 4 neonatal deaths and 409 live babies, with the successful rate of 90.5% (209/231). There were 49 neonates in the singleton group, including 2 cases of fetal loss. Thus the successful rate was 96.1% (49/51). There was no difference of successful pregnancy rate between the two groups (P>0.05). (2) The mean gestational age at operation for the twins group and singleton group were (16.5±3.5) weeks and (14.2±2.0) weeks, respectively. Each group was divided into three periods, 11-13(+6) weeks, 14-16(+6) weeks and ≥17 weeks. In the twins group, the cases in each time period were 129 (55.8%, 129/231), 50 (21.6%, 50/231) and 52 (22.5%, 52/231), respectively. While in the singleton group, the cases in each time period were 27 (53%, 27/51), 16 (31%, 16/51) and 8 (16%, 8/51). There was no difference between the two groups at each time period (P>0.05). (3) The fetal loss rate in the twins group were 7% (9/129), 12% (6/50), 10% (5/52) at each time period, respectively. While for the singleton group they were 4% (1/27), 0 (0/16) and 1/8, respectively. There was no significant difference between the two groups at each time period (P>0.05). (4) The mean birth weight of the twins group was lower than the singleton group [(2,555±447) g vs (3,084±550) g, respectively, P<0.05]. The rates of low birth weight infants (<2,499 g) in the twins group and the singleton group were 45.5% (188/413) and 8% (4/49), respectively (P<0.05). The rate of very low birth weight infants (≤1,499 g) was 3.9% (16/413) in the twins group compared with 0 (0/49) in the singleton group (P>0.05). (5) The gestational age at delivery of the twins group was earlier than the singleton group [(36.2±2.4) weeks vs (38.3±2.2) weeks, respectively, P<0.05]. The labor rate of the two groups was significantly different for both 34-36(+6) weeks and ≥ 37 weeks (P<0.05). The full-term delivery rate in the twins group was 47.6% (110/231), and was 88.2% (45/51) in the singleton group (P < 0.05). The fetal loss rate before 28 weeks did not differ between the two groups [8.7% (20/231) vs 3.9% (2/51), P>0.05].Reduction to one fetus led to significantly better outcome than two fetuses, with no significant difference in fetal loss rate. It is better to advise patients with triplets reduce to singleton pregnancy.
Singleton
Twin Pregnancy
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To study defects and chromosomal abnormalities of the fetus, we retrospectively analyzed results of comprehensive dynamic survey of 26,404 pregnant women aged 18-50 years old at 6 to 40 weeks of pregnancy. Of them, 25,956 (98.3%) women had physiological course of pregnancy, 448 (1.7%) women had abnormal pregnancy. For the diagnosis of fetal defects, we carried out ultrasound, biochemical, invasive and cytogenetic studies. The results of study showed that the majority of fetal defects and pathological course of pregnancy was noted in women at the age of 21-25 years old, since at this age period women have the highest number of pregnancies. At the older age, we noted a gradual decrease in the number of pregnant women, as well as the number of abnormalities of the fetus. Based on the analysis of the results obtained, we have developed an algorithm for early fetal ultrasound examination. In order to exclude non-developing pregnancy and intrauterine fetal death, as well as for early diagnosis of fetal defects, we recommend screening women in the first trimester of pregnancy.
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Objective To study the correlation between the fetal liver volume and gestational age by three-dimensional ultrasound,and to evaluate its clinical significance.Methods Fetal liver volume from 173 normal fetuses,ranging between 22～39 weeks old,was individually measured by three dimensional ultrasound.Results ① The reproducibility of fetal liver volume measurement by three-dimensional ultrasound was well.② The relationship between fetal liver volume and gestational age was linear(r= 0.93,P 0.05),the regression equation was Y= 4.832X- 89.054(R 2= 0.87,P 0.05).Conclusions Three-dimensional ultrasound can accurately measure fetal irregular liver volume without injury,which will be of great clinical importance in measuring fetal organs and will provide basis on evaluating fetal abnormal growth.
Clinical Significance
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Objective To explore the clinical value of early in pregnancy, ultrasound screening and diagnosis of fetal. Methods During 2012 February to 2013 in our hospital were chosen in February to accept early in pregnancy, ultrasound screening and diagnosis of 200 cases of pregnant women, accept ultrasound screening in early pregnancy and pregnant metaphase respectively, statistics of fetal anomaly detection rate and abnormal condition. Results 200 cases, 220 fetus in early pregnancy, ultrasound screening in the check out the 15 fetal abnormality(6.81%); 190 in the second trimester fetal ultrasound screening in the check out the 5 cases of abnormal(2.63%). Conclusion Early pregnancy will check out part of severely abnormal fetus, pregnant metaphase will check out early did not appear abnormal situation. So, to be combined with early in pregnancy, ultrasound screening and diagnosis of fetal anomaly, prenatal diagnosis has important value for clinical.
Abnormality
Early pregnancy factor
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Introduction: Gestational age is frequently estimated based on last menstrual period and on ultrasonography. Many people are unaware of their last menstrual period due to irregular menstruation and ultrasonography is bound to have a bias, thereby posing difficulties in the estimation of gestational age. Placenta is a fetal organ which provides the physiological link between pregnant women and her fetus. Placental growth can be estimated by measuring the thickness and estimating its volume. Placental thickness is directly related to the gestational age of the fetus till certain weeks of pregnancy.
Objectives: To study the correlation between ultrasonographic placental thickness and gestational age of the fetus.
Methods: This is an observational study done at ESIC Medical College & PGIMSR Chennai. 333 cases were recruited for the present study to determine the normal placental thickness for various gestational age and to study the correlation between ultrasonographic measurement of placental thickness and gestational age of the fetus.
Results: Placental thickness for gestational age 11-40 weeks calculated, it gradually increased from 14.6 mm at 11weeks to 38.9mm at 40 weeks gestation. Correlation coefficient is 0.98 and p value
Crown-rump length
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Background: Accurate assessment of gestational age is of paramount importance for the clinician to impart holistic antenatal care and is also essential prerequisite to plan the various clinical tests and interventions. Ultrasound (USG) morphometric measurements of fetal parts have been used to assess gestational age of the fetus with improved accuracy. The present study aims at comparing the ultrasonographic measurement of transverse cerebellar diameter (TCD) with other previously established fetal ultrasound biometric parameters, to study its role in patients of suspected intrauterine growth retardation (IUGR) and to study ultrasonographic appearance of fetal cerebellum with advancing gestational age.Methods: A total of 153 pregnant women who were referred for antenatal ultrasound examination were divided into two groups-Group I had 137 healthy pregnant women with normal fetuses between 14-40 weeks of gestation and Group II had 16 patients suspected to have IUGR clinically.Results: In group I, there was a curvilinear relationship between TCD and BPD, TCD and HC, TCD and AC and TCD and FL with correlation coefficients being 0.9810, 0.9181, 0.9649 and 0.9513 respectively. In group II, TCD correlated with gestational age predicted by last menstrual period. The remaining biometric parameters in group-II predicted a fetus of much earlier grade. The study findings also suggested a gradual and steady change in ultrasonographic appearances of cerebellum with advancing gestation.Conclusions: Ultrasonographic measurement of TCD shows excellent correlation with advancing gestational age and with other previously established biometric parameters. TCD can serve as an independent and reliable indicator of gestational age and a standard against which aberrations in fetal growth may be compared.
Biophysical profile
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A case of twin pregnancy with intrauterine death of one fetus in the 28 th week of pregnancy been described. The pregnancy was actively continued. The following procedure was introduced: 1. Tocolysis, 2. Drugs accelerating lung maturation of the alive fetus, 3. Antinfectious and anticoagulopathy prophylaxis, 4. Special care of the mother and the alive fetus. In the 30 th week of pregnancy spontaneus labor occurred "per via naturales". The macerated dead fetus and the alive premature newborn were born. The baby was charged home in good condition in the 45 th day after delivery.
Intrauterine death
Twin Pregnancy
Fetal death
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