Title: Foetal Kidney Length Comparing Its Efficacy with Other Biometric Parameters as a Parameter for Determination of Gestational Age in Pregnancy by Ultrasonography
Authors: Dr Ruchi Saxena, Dr Gajendra Saxena, Dr Khushboo Joshi, Dr Sunipa, Dr Kamlesh Yadav
DOI: https://dx.doi.org/10.18535/jmscr/v4i12.79
Abstract
Background: Accurate monitoring of fetal gestational age is one of the most critical components of prenatal care. The ability to accurately determine the fetal gestational age and growth was recognizing its abnormal patterns, helps us to decide that if early intervention is necessary in high risk pregnancy or not.
Aims: This study intends to determine the accuracy of fetal gestational age estimation using mean fetal kidney length and comparing its efficacy with other biometric parameters and gestational age derived from last menstrual period as taken as a standard.
Material & Method: This cross section hospital based study period of one year from 2015 to 2016. Pregnant women (n=100) with known dates of different parity and ages were included in this study. The subjects were taken informed before they were enrolled in the study.
Results: In present study, gestational age was ranging from 28 to 40 weeks and their mean BPD was ranging from 68.00 to 98.00 mm (table 2) and their mean femur length was ranging from 53.00 to 78.00mm.
Conclusion: The kidney length is more accurate method of determining gestational age than the fetal biometric indices of biparietal diameter, head circumference, femur length and abdominal circumference between 24 to 38 weeks of gestation. However, large and multicentric studies are required to recommend it.
Keywords: Biparietal Diameter (BPD), Head Circumference (HC), Femur Length (FL) and Abdominal Circumference (AC).
References
1. Bailey C, Carnell J, Vahidnia F, Shah S, Stone M, Adams M, Nagdev A. Accuracy of emergency physician using ultrasound measurement of crown-rump length to estimate gestational age in pregnant females. Am J Emerg Med 2012;30 (8): 1627-1629.
2. Sahota DS, Leung TY, Leung TN, Chan OK, Lau TK. Fetal crown-rump length and estimation of gestational age in an ethnic Chinese population. Ultrasound Obstet Gyecol 2009;33(2): 157-160.
3. Karki DB, Sarma UK, Rauniyar RK . Study of accuracy of commonly used fetal parameters for estimation of gestational age. JNMA J Nepal Med Assoc 2006;45(162): 233-237.
4. Pearce JM, Chazal RD. Establishing gestational age. In: ultrasound in Obstetric and Gynecology. 1st edition, Dewbury K, Meire H, Cosgrove D (Eds), Churchill Livingstone: Edinburg 1993: page 211-221.
5. Hadlock FP, Deter RL, Harrist RB, Park SK. Estimating fetal age: computer assisted analysis of multiple fetal growth parameters. Radiology 1984;152(2): 497-501.
6. Benson CB, Doubilet PM. Sonographic prediction of gestational age: accuracy of second and third trimester fetal measurements. AJR Am J Roentgenol 1991; 157 (6): 1275-1277.
7. Konje JC, Abrams KR, Bell SC, Taylor DJ. Determination of gestational age after the 24th week of gestation from fetal kidney length measurements. Ultrasound Obstet Gynecol 2002;19 (6): 592-597.
8. Yousuf N, Moslem F, Haque JA. Fetal kidney length: can be a new parameter for determination of gestational age in third trimester. TAJ 2007; 20(2): 147-150.
9. Cannie M, Neirynck V, De Keyzer F, Dymarkowski S, Bogaert GA. Prenatal magnetic resonance imaging demonstrates linear growth of the human fetal kidneys during gestation. J Urol 2007;178(4): 1570-1574.
10. Kaul I, Memia V, Anand AK, Gupta R. Role of fetal kidney length in estimation of gestational age. JK Science 2012;14(2): 65-69.
11. Cohen HL, Cooper J, Eisenberg P, Mandel FS, Gross BR, Goldman MA et al. Normal length of fetal kidney: Sonographic study in 397 obstetric patients. AJR Am J Roentgenol 1991;157(3):545-548.
12. Kurtz AB, Wapner RJ, Kurtz RJ. Analysis of biparietal diameter as an accurate indicator of gestational age. J Clin Ultrasound 1980;8:319-326.
13. Doubilet PM, Benson CB. Improved prediction of gestational age in the late third trimester. J Ultrasound Med 1993;12: 647-653.
14. Law RC, MacRac KD. Head circumference as an index of fetal age. J Ultrasound Med 1982;1: 281-288.
15. Hadlock FP, Deter RL, Harrist RB. Fetal abdominal circumference as a predictor of menstrual age. AJR 1982;139: 367-370.
16. Hadlock FP, Harrist RB, Carpenter RJ. Sonographic estimation of fetal weight; the value of femur length in addition to head and abdomen measurements. Radiology 1984;150: 535-540.
17. Jeanty PJ, Rodesch F, Delbeke D et al. Estimation of gestational age from measurement of fetal long bones. J Ultrasound Med 1984;3: 75-79.
18. Jeanty P, Cantraine F, Cousaert E. The binocular distance; a new way to estimate fetal age. J Ultrasound Med 1984;3: 241-243.
19. Rosenbaum D, Korngold E,Tele R. Sonographic assessment of lengths in normal children. AJR 1984;142: 467-469.
20. Han B, Babcock D. Sonographic measurements and appearance of normal kidneys in children. AJR 1985;145: 611-616.
21. Fitzsimons R. Kidney length in the newborn measured by ultrasound. Acta Paediatr Scant 1983;72: 885-887.