Estimation Of Gestational Age Research Articles

Evaluation of Fetal Clavicular Length as a Sonological Parameter for the Estimation of Gestational Age

Evaluation of Fetal Clavicular Length as a Sonological Parameter for the Estimation of Gestational Age

Estimation of Gestational Age by Using Fetal Kidney Length and Transcerebellar Diameter in Comparison with Other Biometric Indices

Estimation of Gestational Age by Using Fetal Kidney Length and Transcerebellar Diameter in Comparison with Other Biometric Indices

Sonographic measurement of ear length among normal fetuses of pregnant Igbo women in port Harcourt, Nigeria.

Fetal ear length measurement has been associated with some clinical values: sonographic marker for chromosomal aneuploidy and for biometric estimation of fetal gestational age. To establish a baseline reference value for fetal ear length and to assess relationship between fetal ear length and gestational age. Ear length measurements were obtained prospectively from fetuses in 551 normal singleton pregnancies of 15 to 41 weeks gestation. Normal cases were defined as normal sonographic findings during examination plus normal infant post-delivery. The relationship between gestational age (GA) in weeks and fetal ear length (FEL) in millimeters were analyzed by simple linear regression. Correlation of FEL measurements with GA, biparietal diameter (BPD), Head circumference (HC), Abdominal Circumference (AC), Femur Length (FL) and maternal age (MA) were also obtained. Linear relationships were found between FEL and GA (FEL=0.872GA-2.972). There was a high correlation between FEL and GA (r = 0.837; P = .001). Good linear relationship and strong positive correlation were demonstrated between FEL and BPD, AC, HC, and FL (p<0.05). The result of this study provides normal baseline reference value for FEL. The study also showed good linear relationship and good correlation between FEL and fetal biometric measurements.

Quantitative anatomy of the fused ossification center of the occipital squama in the human fetus.

CT-based quantitative analysis of any ossification center in the cranium has not previously been carried out due to the limited availability of human fetal material. Detailed morphometric data on the development of ossification centers in the human fetus may be useful in the early detection of congenital defects. Ossification disorders in the cranium are associated with either a delayed development of ossification centers or their mineralization. These aberrations may result in the formation of accessory skull bones that differ in shape and size, and the incidence of which may be misdiagnosed as, e.g., skull fractures. The study material comprised 37 human fetuses of both sexes (16♂, 21♀) aged 18–30 weeks. Using CT, digital image analysis software, 3D reconstruction and statistical methods, the linear, planar and spatial dimensions of the occipital squama ossification center were measured. The morphometric characteristics of the fused ossification center of the occipital squama show no right—left differences. In relation to gestational age, the ossification center of the occipital squama grows linearly in its right and left vertical diameters, logarithmically in its transverse diameters of both the interparietal and supraoccipital parts and projection surface area, and according to a quadratic function in its volume. The obtained numerical findings of the occipital squama ossification center may be considered age-specific references of relevance in both the estimation of gestational age and the diagnostic process of congenital defects.

Study of fetal hemoglobin with different gestational age and birth weight of the newborn

Background: In many parts of the developing country estimation of antenatal gestational age is still not possible and challenging condition of proper perinatal care. This study aimed to find out relationship between the gestational age and birth weight of the newborn with fetal hemoglobin concentration.Methods: In this comparative study, we included 90 pregnant women who delivered their babies by normal vaginal delivery. Out of these 90 babies, 27 were preterm with gestational age 28-36 weeks, 55 were term with gestational age 37-41 weeks and remaining 8 were post term with gestational age of more than 41 weeks. All these 90 newborn infants were also divided into two groups: low birth weight (birth weight &lt;2.5 kg) and birth weight ≥2.5 kg. Fetal hemoglobin was estimated by using alkali denaturation technique of Chernoff and Singer on appropriate spectrophotometer. Statistical analysis was performed using SPSS windows version 20.0 software.Results: The total number of newborns were significantly (p&lt;0.001) higher in term group and with normal birth weight group. Fetal hemoglobin level was significantly (p&lt;0.0001) lower in term, post term and normal birth weight groups. Study showed a definite negative correlation between gestational age and the fetal hemoglobin concentration. Fetal hemoglobin level was gradually declining with increasing gestational age and birth weight.Conclusions: It is concluded from this study that the concentration of fetal hemoglobin decreases at the rate of 2.4% per week with considerable variation of values at every week of advancing gestational age. Hence level of fetal hemoglobin estimation can be taken as an important criterion for evaluation of gestational age.

An automated framework for image classification and segmentation of fetal ultrasound images for gestational age estimation.

Accurate assessment of fetal gestational age (GA) is critical to the clinical management of pregnancy. Industrialized countries rely upon obstetric ultrasound (US) to make this estimate. In low- and middle- income countries, automatic measurement of fetal structures using a low-cost obstetric US may assist in establishing GA without the need for skilled sonographers. In this report, we leverage a large database of obstetric US images acquired, stored and annotated by expert sonographers to train algorithms to classify, segment, and measure several fetal structures: biparietal diameter (BPD), head circumference (HC), crown rump length (CRL), abdominal circumference (AC), and femur length (FL). We present a technique for generating raw images suitable for model training by removing caliper and text annotation and describe a fully automated pipeline for image classification, segmentation, and structure measurement to estimate the GA. The resulting framework achieves an average accuracy of 93% in classification tasks, a mean Intersection over Union accuracy of 0.91 during segmentation tasks, and a mean measurement error of 1.89 centimeters, finally leading to a 1.4 day mean average error in the predicted GA compared to expert sonographer GA estimate using the Hadlock equation.

A Comparison of the Accuracy of Various Methods of Postnatal Gestational Age Estimation; Including Ballard Score, Foot Length, Vascularity of the Anterior Lens, Last Menstrual Period and Also a Clinician's Non-Structured Assessment.

Gestational age is a strong determinant of neonatal mortality and morbidity. Early obstetric ultrasound is the clinical reference standard, but is not widely available in many developing countries. A prospectively designed diagnostic accuracy study in a tertiary referral hospital in a developing country. Early ultrasound (<20 weeks) was the clinical reference standard. Methods evaluated included anthropometric measurements (including foot length), vascularity of the anterior lens, the New Ballard Score and last menstrual period. Clinicians' non-structured global impression 'End of Bed' Assessment was also evaluated. 106 babies were included in the study. Median age at birth was 34 weeks (interquartile range 29-36). Ballard Score and 'End of Bed' Assessment had a mean bias of -0.14 and 0.06 weeks respectively but wide 95% limits of agreement. The physical component of the Ballard score, the total Ballard score and Foot length's ability to discriminate between term and preterm infants gave an area under the receiver operating characteristics curve of 0.97, 0.96 and 0.95, respectively. Although 'End of Bed' Assessment and Ballard score had small mean biases, the wide confidence intervals render the methods irrelevant in clinical practice. Foot length was particularly poor in Small for Gestational Age infants. None of the methods studied were superior to a non-structured clinician's informal 'End of Bed' Assessment. None of the methods studied met the a priori definition of clinical usefulness. Improving access to early ultrasound remains a priority. Instead of focusing on chronological accuracy, future research should compare the ability of early ultrasound and Ballard score to predict morbidity and mortality. Lay summary. Gestational age describes the time interval between conception and the delivery of the baby. Babies born before 37 weeks of gestation (preterm) or after 42 weeks of gestation (post-dates) have an increased risk of death and specific illnesses. The best way to estimate the gestational age is to perform an ultrasound scan on the mother before 20 weeks. However, this is not widely available in many developing countries. Methods to estimate gestational age after birth include calculating the time from the last period, various measurements of the child (such as weight, foot length or head circumference) physical and neurological markers of maturity and examination of the blood vessels on the lens in the eye. In this study, we assessed how accurate these methods were when compared with the best available method; early ultrasound. We also analyzed the clinicians own personal feeling of what the most likely gestation was, based on an informal 'end of bed' assessment. If a method was to be deemed clinically useful it was agreed that it would have to confidently identify the gestation to within 1 week of the true gestation. None of the methods studied could confidently predict the gestational age of individual babies within 1 week. Ballard scoring and the clinician's informal 'End of Bed' Assessment were the most accurate and also had the smallest inter-operator variability when the results of two separate researchers were compared. Foot length performed particularly badly with babies who were small for their gestational age. None of the methods studied confidently predicted gestational age within a week, so have little use in clinical practice. Access to early ultrasound should be improved. Further research into the relationship between maturity markers such as the Ballard score and the rates of death and specific premature related illnesses is warranted.

Metabolic gestational age assessment in low resource settings: a validation protocol.

Preterm birth is the leading global cause of neonatal morbidity and mortality. Reliable gestational age estimates are useful for quantifying population burdens of preterm birth and informing allocation of resources to address the problem. However, evaluating gestational age in low-resource settings can be challenging, particularly in places where access to ultrasound is limited. Our group has developed an algorithm using newborn screening analyte values derived from dried blood spots from newborns born in Ontario, Canada for estimating gestational age within one to two weeks. The primary objective of this study is to validate a program that derives gestational age estimates from dried blood spot samples (heel-prick or cord blood) collected from health and demographic surveillance sites and population representative health facilities in low-resource settings in Zambia, Kenya, Bangladesh and Zimbabwe. We will also pilot the use of an algorithm to identify birth percentiles based on gestational age estimates and weight to identify small for gestational age infants. Once collected from local sites, samples will be tested by the Newborn Screening Ontario laboratory at the Children's Hospital of Eastern Ontario (CHEO) in Ottawa, Canada. Analyte values will be obtained through laboratory analysis for estimation of gestational age as well as screening for other diseases routinely conducted at Ontario's newborn screening program. For select conditions, abnormal screening results will be reported back to the sites in real time to facilitate counseling and future clinical management. We will determine the accuracy of our existing algorithm for estimation of gestational age in these newborn samples. Results from this research hold the potential to create a feasible method to assess gestational age at birth in low- and middle-income countries where reliable estimation may be otherwise unavailable.

Comparison of Expanded New Ballard, Eregie and Parkin Scores in Predicting Gestational Age in Newborns

Background: Postnatal gestational age (GA) estimation is crucial in neonates with absent early trimester ultrasonography (USG) reports to evaluate the risk of morbidity and mortality. Widely used Expanded New Ballard (ENBS) is complex and needs expert medical professional to assess. Eregie (ES) and Parkin (PS) scores are easy to perform with good inter-observer reliability. We aimed to compare these scores for their ability in predicting GA with early trimester USG-GA as gold standard. Methods: This cross-sectional study was conducted among 1114 intramural neonates who qualified the selection criteria. All neonates were evaluated using three scores by residents (blinded to USG-GA) with an acceptable inter-observer difference of <10%. Method applicability was compared in terms of agreement, correlation, accuracy and validity. Results: Gestational age was systematically overestimated by 0.65 weeks, 0.68 weeks, and 0.32 weeks by ENBS, PS and ES respectively. Correlation coefficient was highest for ENBS (ρ value 0.724). For GA sub-groups, ES had best overall accuracy with MD of 0.32 ± 0.88 weeks. Validity was highest for ES (79.6%). Interpretation: We conclude that all three scores were found to be in acceptable agreement, good accuracy and validity. ES had best overall accuracy and validity among the subjects and for subgroups. Hence we recommend that in limited resource settings, ES or PS can substitute for ENBS. Funding: None. Declaration of Interests: None. Ethics Approval Statement: Ethical clearance was obtained from Institutional Human ethics Committee, Mahatma Gandhi Medical College and Research Institute (MGMCRI), Pondicherry, India. All the parents of the participants provided written informed consent before participation.

Correlation between Gestational Age and Abdominal Circumference in Second Trimester

Gestational age is age of unborn baby, defined in weeks as beginning from first day of last menstrual periodprior to conception. Estimation of gestational age and thereby forecasting Expected Date of Delivery is notonly concern of the Individual but it is invaluable in the diagnosis of intrauterine growth retardation of fetusand obstetric planning. Determination of age of a fetus by using various methods is required for medico legalpurposes in both civil and criminal matters. In present study we assesses Correlation between gestationalage and abdominal circumference in second trimester, The study of Correlation between gestational ageand abdominal circumference in second trimester by Ultrasonography was carried out and collected datawas tabulated according to weeks of menstrual cycle and were taken in centimeters. Standard deviationof abdominal circumference for each week was calculated. We found that Abdominal Circumference isstatistically highly significant and the regression equations derived for growth parameter for estimatinggestational age in a normally developing fetus, increase with gestational age, showed good correlation withgestational age.

Estimation of gestational age using foetal kidney length during second and third trimester in south Indian population

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.&#x0D; 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).&#x0D; 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.&#x0D; 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.

Role of Ultrasonographic Measurement of Fetal Kidney Length in Determination of Gestational Age during Third Trimester of Pregnancy

Background: In routine ultrasonography, the ultrasonologist measures the bi-parietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) in estimating the gestational age (GA) and estimated date of delivery. However, as the pregnancy advances these parameters become increasingly unreliable in prediction of GA. Estimation of GA in late second and third trimester accurately still a problem till now. Fetal kidney has been shown a steady growth of 1.7 mm fortnightly (every 2 weeks) along pregnancy and is unaffected by growth abnormalities. Many studies have reported that fetal kidney length (FKL) correlates with the gestational age in late trimester very strong. The study aimed to assess the accuracy of the gestational age estimated by mean fetal kidney length compared to multiple growth parameters like BPD, HC, AC & FL in addition to the actual gestational age derived from the reliable last menstrual period. Methods: Cross sectional hospital based study, was conducted at ultrasound unit; department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University from the period of July 2018 to December 2018. A total number of 115 Pregnant women at their third trimester by reliable LMP attended antenatal care clinic at Ain-Shams University Hospital and consented to participate in this study. Every woman was subjected to: Expected date of delivery was calculated according to Naegle’s formula: Ultrasonography: Fetal biometry and estimated date of delivery (EDD) by assessment of BPD, HC, FL & AC. Expected fetal weight measured by Hadlock formula. Fetal lie and presentation. Exclusion of fetal anomalies. Measurement of both right & left fetal kidney length. Results: In this study, 255 participants were recruited and assessed for eligibility, 125 women were allocated to perform obstetric ultrasound just 115 completed and were included in the final analysis. The current study found that there was a highly significant positive correlation between gestational age (according to ultrasound parameters) and KL, BDP, HC, AC and FL but Kidney length was the most correlated parameter. Also this study found that there was significant positive correlation between gestational age (according to LMP) and gestational age estimated by BPD, HC, AC, FL and KL with the most significant positive correlation being with KL. Also this study found that there was no significant difference (matched) in KL and Gestational age compared to other parameters. This means that KL is the most accurate parameter for Estimating Gestational age, correlation between MKL and GA by LMP (r = 0.951, p = 0.000) the most significant correlation. In this study, no significant difference was found between gestational age estimated by KL and gestational age in all stages of pregnancy. This means that KL remains accurate as a predictor for gestational age regardless stage of pregnancy. Conclusion: Kidney length can be used as an individual parameter in estimating gestational age.

ULTRASOUND MEASUREMENT OF FETAL KIDNEY LENGTH AS A PARAMETER FOR GESTATIONAL AGE DETERMINATION

Background: Accuracy in estimation of gestational age (GA) has become more demanding as technology used in ultrasonography has become more advanced. Patient’s expectations have also increased and they expect exact estimations to plan their pregnancies. Mean fetal kidney length (MFKL) alone or in combination with other biometric indices can be used for estimating GA more precisely. Objective: To measure the length of fetal kidney in normal singleton pregnancies in late second and early third trimesters, its correlation with GA derived from the first day of patient known last menstrual period (LMP) and comparison with GA derived from other conventional biometric methods. Patients and methods: This study was a prospective observational study, conducted at the department of Obstetrics & Gynecology, Obstetrics & Gynecology Hospital, Assiut, 500 pregnant females were enrolled in this study from March 2018 to March 2020. Those women underwent measurement of the right and left kidneys and mean was taken. Comparison between gestational ages was determined by LMP. In addition, mean fetal kidney length as well as between mean fetal kidneys length and other fetal biometric indices was done. Results: Baseline data of enrolled women (n= 500) mean age of those women was 26.31 ± 4.87 years. Median parity and abortion was 2 with range of both was between 0-6 and 0-8 times, respectively. Mean gestational age was 30.29 ± 3.34 weeks while mean body mass index was 19.84 ± 1.20 kg/m2. Average fetal kidney length was 29.88 ± 3.33 mm. Gestational ages based on different fetal biometric indices. Age by date had strong positive significant correlation with different fetal indices but the strongest correlation was observed with mean fetal kidney length (r= 0.96, P< 0.001). Correlation between gestational age by date and expected age by MFKL based on regression equation. That there was significant strong positive correlation between gestational age and expected age by MFKL (r= 0.97; P< 0.001). Conclusion: Mean fetal kidney length can be used as an accurate new parameter for estimation of gestational age in combination with BPD, HC, AC & FL especially in late second and early third trimester (beginning from 24th week – 34th week). Using regression equation: Gestational age by date (weeks) = 1.56+ 0.97 (MKL in mm).

Evaluation of serum presepsin concentrations as a biomarker of sepsis in high-risk neonates

Background Sepsis is a common cause of morbidity and mortality among neonates. The clinical usefulness of assessment of presepsin concentration was studied and compared with other laboratory parameters in a prospective case–control study. Patients and methods A prospective case–control study was carried out in the neonatal intensive care unit of Al-Azhar University Hospital (Assiut, Egypt) from July 2016 to July 2018. The authors enrolled 80 newborns: 40 at high risk of neonatal sepsis (group A), 20 septic (group B) according to Tollner clinical sepsis score greater than 2 and/or positive blood culture, and 20 controls (group C). Full medical history, clinical examination, estimation of gestational age by new Ballard score, and laboratory investigations were done. Presepsin, C-reactive protein (CRP), complete blood count, and blood culture were done during first day (D1) of admission for all neonates. Additional measurements of presepsin and CRP were done at D3 for group A, and another measurement at D5 for neonates who have increased CRP and/or appearance of signs of sepsis (group A) at D3. Result Initial levels of serum presepsin in 80 neonates ranged from 293 to 1648 pg/ml. Presepsin had a significant difference between groups A and B (692.9±79.49 and 1327.3±208.41 pg/ml, respectively; P&lt;0.001***). In group A, neonates who developed clinical signs of sepsis, presepsin levels had significant difference between D1, D3, and D5 (P&lt;0.001***). Presepsin had a significant difference between full-term and preterm neonates (P&lt;0.001***). There was a positive correlation of presepsin with CRP and white blood cells (r=0.580 and 0.546, respectively). Coagulase-negative staphylococci were the most isolated organism. The receiver operating characteristic curve of presepsin at enrollment shows an area under the curve of 0.99. The best calculated cutoff value was greater than or equal to 722 pg/ml, with 100% sensitivity and 97.5% specificity. Conclusion Presepsin level changes early in the disease course, so it can be used as a reliable biomarker for early diagnosis of neonatal sepsis, and it is a promising marker for detection of improvement.

Estimation of Gestational Age by Ultrasound Measurement of Fetal Transcerebellar Diameter

Introduction: Transcerebellar diameter (TCD) normogram predicts gestational age (GA) with an accuracy of 94% in the third trimester. The study aims to evaluate the application and accuracy of Transcerebellar diameter in determining the GA of the fetus and Its Correlation. Material and Methods: A cross-sectional prospective study conducted to determine the different antenatal ultrasound examinations were performed in 100 normal healthy pregnant with single fetus women having between 25 and 32 weeks of gestation. Results: Mothers mean GA on ultrasound was 28.4 ± 0.75 (27–30.2) weeks. The mean fetal biometry parameters including biparietal diameter (BPD) was 73 ± 2.3 mm (67–80), head circumference (HC) was 264 ± 8.7 mm (237.8–311), abdominal circumference (AC) was 244 ± 8.9 mm (226.6–265.9), femur length (FL) was 55 ± 2.1 mm (49.5–59.6), fetal heart rate was 149 ± 8.5 beats (121–175). The mean transcerebellar (TCD) measurement was 31 ± 1.1 mm. The correlation coefficient between the period of gestation and TCD was found to be 0.99 at 27–30 weeks which was statistically significant (P &lt; 0.001) (r &gt; 0.99). Discussion and Conclusion: From the present study, it was observed that the TCD increases linearly with GA. The correlation between GA and the GA by TCD seems to increase from 28 to 30 weeks. There is a good correlation between GA derived from TCD and from established biometric indices like BPD, HC, AC, and femur length.

Sonographic Placental Thickness Measurement: A Trustworthy Saviour for Foetal Age Estimation in Uncomplicated Pregnancy

Introduction: Placenta is a foeto-maternal organ playing a crucial role in endocrine, immunological, excretory, respiratory, and nutritional functions for the foetus. Gestational age estimation is usually based on the last menstrual period and ultrasonography. Many females having irregular menstruation present with unreliable last menstrual period and hence ultrasonography comes into play for correctly estimating the gestation. Various sonologically derived foetal parameters used for gestational age estimation are Crown Rump Length (CRL), Biparietal Diameter (BPD), Head Circumference (HC), and Abdominal Circumference (AC). The placental thickness measurement shows a direct correlation with the gestational age of the foetus till certain weeks of pregnancy, therefore could be utilised as a new and simple parameter in scenarios like term pregnancy where other parameters are unreliable. Aim: To study the relationship between sonographic placental thickness measurement and gestational age of the foetus and also correlating other biometric parameters i.e., BPD, AC, femur length with placental thickness. Materials and Methods: The present study was a cross- sectional study conducted in the Department of Radiodiagnosis, in collaboration with the Department of Obstetrics and Gynaecology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India. Sample size constituted of 200 normal antenatal women in whom the placental thickness for various gestational age and correlation between placental thickness measurement with the gestational age of the foetus was done. Analysis of the relationship between placental thickness and other foetal parameters like BPD, femur length and AC was also assessed using Pearson correlation coefficient. Results: Placental thickness measurements for gestational age 11-39 weeks were calculated; it gradually increased from 11.29 mm (mean) at 11 weeks to 35 millimeters (mm) (mean) at 39 weeks of gestation. Correlation coefficient was 0.9685 and p-value &lt;0.01. Also, there was a significant positive correlation of placental thickness with other foetal biometry parameters like BPD, femur length and AC (p&lt;0.001). Conclusion: The measurement of placental thickness can become a key parameter for estimation of foetal age especially in cases where the exact duration of pregnancy is not known. It can also facilitate the detection of abnormal placental thickness associated with maternal and foetal complications in the early stages.

The Association of COVID-19 Infection in Pregnancy With Preterm Birth: A Retrospective Cohort Study in California

Background: Our understanding of the association of coronavirus disease 19 (COVID-19) and preterm or early term birth among racially and ethnically diverse populations and those with chronic medical conditions is limited. Methods: We examined the relationship between COVID-19 and preterm (PTB) birth among live births documented by California Vital Statistics birth certificates between July 2020 and January 2021 (n=240,147). We used best obstetric estimate of gestational age to classify births as very preterm (VPTB, Findings: COVID-19 diagnoses on birth certificates increased for all racial/ethnic groups between July 2020 and January 2021, and was highest for American Indian/Alaska Native (12.9%), Native Hawaiian/Pacific Islander (11.4%), and Latinx (10.3%) birthing people. COVID-19 diagnosis was associated with an increased risk of VPTB (aRR 1.6, 95% CI [1.4, 1.9]), PTB (aRR 1.4, 95% CI [1.3, 1.4]), and early term birth (aRR 1.1, 95% CI [1.1, 1.2]). There was no effect modification of the overall association by race/ethnicity or insurance status. COVID-19 diagnosis was associated with elevated risk of PTB in people with comorbidities. Interpretation: In a large population-based study, COVID-19 diagnosis increased the risk of VPTB, PTB, and early term birth, particularly among those with medical comorbidities. Prevention measures, including vaccination, should be prioritized for birthing persons. Funding Information: UCSF-Kaiser Department of Research Building Interdisciplinary Research Careers in Women’s Health Program (BIRCWH) National Institute of Child Health and Human Development (NICHD) and the Office of Research on Women’s Health (ORWH) [K12 HD052163] and the California Preterm Birth Initiative, funded by Marc and Lynn Benioff.Declaration of Interests: The authors have no conflicts of interest to disclose.Ethics Approval Statement: The Committee for the Protection of Human Subjects (CPHS) within the Health and Human Services Agency of the State of California approved study protocols.

Evaluation of ultrasonographic fetal kidney length for gestational age detection in late second and third trimesters

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 &amp; (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 &amp; engagement as well as inter &amp; intra observer measurement variation.Ultrasonic measurement of fetal biometry (CRL, BPD, FL) are considered to be reliable when they are performed in first &amp; early 2nd trimester (&lt;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.

Two-Dash Line: A New Approach for Prenatal Ultrasound Measurement of Iliac and Ischial Bones to Estimate Gestational Age.

There has been a dearth of an accurate and reliable method for the measurement of fetal pelvic bones. In this study, we describe a novel, easy-to-use method for ischial and iliac bone measurement in fetal ultrasound scanning. This prospective cross-sectional study was performed on 1179 pregnant women at 12 to 40 weeks of an uneventful gestation. Pelvic biometric indices, including the length of the ilium and ischium, were measured by a novel and easy method. Then data were analyzed by regression models to develop a formula for gestational age (GA) estimation based on pelvic bones. The approximate ossification time of the ischium was determined to range between the 13th and 20th gestational weeks. We calculated 3 formulas using linear regression models: formula 1, GA (days)=92.563 + (11.604 × ischial length); formula 2, GA (days)=57.006 + (7.819 × iliac length); and formula 3, GA (days)=65.809 + (5.610 × iliac length) + (3.431 × ischial length). The 2-dash line method can contribute to efficient and precise ultrasound measurement of the ilium and ischium in pelvic biometry of the fetus.

INNOVATE GESTATIONAL AGE ESTIMATION MODEL FOR IRAQI FETUSES BASED ON ULTRASOUND IMAGES MEASUREMENTS

Imaging by Ultrasound (US) is an accurate and useful modality for the assessment of gestational age (GA), estimation fetal weight, and monitoring the fetal growth during pregnancy, is a routine part of prenatal care, and that can greatly impact obstetric management. Estimation of GA is important in obstetric care, making appropriate management decisions requires accurate appraisal of GA. Accurate GA estimation may assist obstetricians in appropriately counseling women who are at risk of a preterm delivery about likely neonatal outcomes, and it is essential in the evaluation of the fetal growth and detection of intrauterine growth restriction. There are many formulas are used to estimate fetal GA in the world, but it's not specify for Iraqi population and leading to some error in GA estimation results, so the objective of this study is to innovate GA estimation model for Iraqi people. This study was performed in the department of Obstetrics and Gynecology in Al- Yarmouk Teaching Hospital and AL- Alawiya Teaching Hospital in Baghdad, Iraq, during 2019 on 200 pregnant women of singleton and normal pregnancies, fetal GA (20-40) weeks (W). The obtained dataset (fetal biometry), were utilized to create GA estimation model in Iraq using IBM SPSS Version 23 software package (IBM^® Software). The statistical analysis of proposed GA model showed, the correlation (R) of model is 0.987 it is very high value and this is a good result to obtain the best regression model. as well as the Std error of Estimation was 0.61095 this is very small value and indicate the best result. The significant of model P=0.000 That means the model, as a whole, is a significant fit to the data (because P &lt; 0.05).