Fetal Gestational Age Research Articles

Correlation of Sonographic Gestational Age with Fetal Kidney Length in Normal Pregnancy

Precise evaluation of gestational age is essential for quality maternity care. Ultrasonography is the most readily available and reliable method to establish gestational age. This study aims to use the length of the fetal kidney as a reliable parameter to measure gestational age in late second and third trimesters. Objective: To determine the relationship between fetal kidney length and gestational age in weeks during the late 2nd and 3rd trimester of normal pregnancy. Methods: It was a prospective cross-sectional study conducted on 105 singleton normal pregnant females between 24th and 40th weeks of gestation who came to the obstetrics and gynecology department at a private sector hospital in Kharian, Pakistan. The duration of the study was four months. Bi-parietal diameter, femur length, and fetal kidney lengths were measured. Statistical analyses were applied using SPSS version 22.0. Results: A moderately significant positive correlation was identified between different gestational age measuring parameters and fetal kidney length. The correlation was significant at the level of 0.01. The correlational values of GA according to LMP with FKLL and FKLR were (r= .85**) and (r= .87**) respectively. GA with BPD indicates a moderately significant positive correlation with FKLL and FKLR (r= .94**) and (r=.94**). GA with FL also shows a moderately significant positive correlation with FKLL and FKLR (r= .83**) and (r= .83**), respectively. Conclusion: In conclusion, fetal kidney length in millimeters correlates well with gestational age in weeks and shows linear growth with gestational age throughout pregnancy. Gestational age estimated from fetal kidney length gives improved dating of fetal age

Fetal biometry is assessment of fetal growth restriction in Telangana region

Background: Intrauterine increase restriction (IUGR) is most common complication in pregnancy and affects morbidity and mortality in any respect degrees of life. With current Doppler research of the fetal important circulation, inclusive of intracardiac flows and the ductus venosus, higher timing of shipping to decrease morbidity can be possible. Serial ultrasound measurements can offer an inexpensive estimate of fetal gestational age and weight primarily based totally on person and composite fetal biometric measurements. Materials and methods: This study consists of pregnant women who are attending OP /IP in department of OBG, SVS medical college, Mehabubnagar, Telanagana. All the retrospective USG quantitative data was noted in case proforma. Sample size was 100 in our study and was divided into cases and controls. Results: In 2nd trimester FGR parameters like FL (30.32), BPD (41.74), AC (136.34), HC (185.36) , GA (20.22) and EFW (310.04) were less when compared to normal fetus. In 3nd trimester we observed FL (61.44), BPD(79.64), AC(287.54) , HC(314.06) , GA (32.06) and EFW (1695.60) which were less when compared to normal fetus. Conclusion: that all the parameters in FGR from 2nd and 3rd trimester were less when compared to normal.

A Conceptual Framework for Fetus Head Analysis Based on Ultrasound Images.

Ultrasound images are the most used imaging methodologies in obstetrics to monitor the growth of a fetus during the gestation period. In particular, the obstetrician uses fetus head images to monitor the growth state and identify essential features such as Gestational age (GA), estimated fetus weight (EFW), and brain anatomical structures. However, this work requires an expert obstetrician, and it is time-consuming and costly. Therefore, we proposed an automatic framework by adopting a hybrid approach that combines three components i) automatic segmentation to segment the region of interest (ROI) in the fetus head, ii) measurement extraction to measure the segmented ROI, and iii) anomaly and features detection to predict fetus GA, EFW, and abnormality status.

Role of Sonographic Measurement of Fetal Foot Length in Estimating Gestational Age: A Hospital Based Study in South Punjab

OBJECTIVE: To highlight the usefulness of ultrasonographic measurement of fetal foot length in determining fetal gestational age.
 STUDY DESIGN: Prospective validation study
 PLACE AND DURATION OF STUDY: Radiology Department Combined Military Hospital Bahawalpur from 01July 2020 to 31Dec 2020.
 METHODOLOGY: Women referred from our obstetrics OPD for antenatal ultrasound between 16 to 40 weeks were scrutinized through inclusion and exclusion criteria for selection in the study. Record of their age, parity, gestational age by LMP and sonographic measurement of fetal foot length were endorsed on a study proforma. After the end of study period, the data was entered in SPSS version 20 to measure Pearson correlation coefficient and R2 values for highlighting the correlation between two variables. P value < 0.01 is taken as significant. 
 RESULTS: A total of 153 patients were included in the study. Mean age of patients in our study is 28.64 years and second parity is most frequent being 41.8%. Data entered in SPSS version 20 for regression analysis. Pearson correlation coefficient (R) is 0.988 and R2 value is 0.977 (P- 0.000) which shows powerful linear correlation between our two variables.
 CONCLUSION: The results of our study shows excellent reliable linear correlation between fetal foot length and gestational age by LMP. Therefore, the fetal foot length so measured by ultrasonography can be used confidently for determination of gestational age in routine or when other ultrasonographic measurement parameters become unreliable.
 KEYWORDS: Fetal foot length, Gestational age, Ultrasonographic age estimation.

Impact of introduction of the growth assessment protocol in a South Indian tertiary hospital on SGA detection, stillbirth rate and neonatal outcome

India has a high rate of stillbirths, and many deaths are due to fetal growth restriction and potentially preventable. Screening and identification of the small for gestational age (SGA) fetus during the antenatal period has been shown to reduce stillbirths. We set out to evaluate the impact of implementing the Growth Assessment Protocol (GAP), a programme designed for screening for SGA. Observational study comparing two-time epochs; before (years 2011-2014) and after (years 2015-2018) introduction of GAP. The programme includes identification of risk factors, risk categorization, serial fundal height measurement, customised fetal growth charts and appropriate referral protocols. Fetal growth charts and birth centiles were generated based on the hospital database of normal outcome pregnancies, customised to women's ethnicity, parity, height, and weight. The protocol was introduced following training of obstetric and midwifery care providers. We evaluated SGA detection rates, stillbirth rates (from 28weeks) and neonatal morbidity at term. There were 26,199 and 31,498 births, with 115 and 108 stillbirths in the pre and post-GAP implementation periods, respectively. SGA detection rates increased from 51.1 to 67.1%, representing a 31% improvement (p<0.001). Overall stillbirth rates declined from 4.4 to 3.4 per 1000 births (RR 0.78 CI 95% 0.60-1.02) and at term from 1.5 to 0.6 (RR 0.37 CI 95% 0.20-0.66). Neonatal intensive care admission and neonatal encephalopathy in term neonates also decreased significantly. Introduction of the GAP programme in an Indian tertiary maternity service was associated with improved antenatal detection of SGA and reduced stillbirth rates and neonatal morbidity.

Factors influencing parental decisions to terminate pregnancies following prenatal diagnoses of major fetal anomalies at Ramathibodi Hospital, Bangkok, Thailand

BackgroundThe rate of termination of pregnancy (TOP) for fetal anomalies and the factors affecting TOP vary among different populations. Optimisation of prenatal care and counselling requires understanding the factors influencing parental decisions in the relevant population. This study aimed to evaluate the rate of TOP after diagnoses of major fetal anomalies and assess factors associated with TOP-related decisions at a university hospital in Thailand.MethodsA retrospective chart review was conducted at the Fetal Anomaly Clinic of Ramathibodi Hospital, Bangkok, Thailand. Medical records of all women with singleton pregnancies prenatally diagnosed with major fetal anomalies before 24 gestational weeks between 2010 and 2020 were reviewed.ResultsDuring the study period, 461 cases of major fetal anomalies were diagnosed, and 264 (57.3%) of these pregnancies were terminated. Three factors influencing parental TOP decisions were lethal anomalies (odds ratio [OR], 197.39; 95% confidence interval [CI], 49.95–779.95; p < 0.001), presence of genetic abnormalities (OR, 10.19; 95% CI, 4.17–24.87; p < 0.001) and gestational age at diagnosis (OR, 0.74; 95% CI, 0.65–0.84; p < 0.001).ConclusionsOver half of the pregnant women whose records were reviewed and who were prenatally diagnosed with major fetal anomalies terminated their pregnancies. Fetal factors, particularly lethality, genetic abnormalities and early gestational age at diagnosis, showed the most powerful associations with parental TOP decisions. Other maternal background factors were not key considerations.

Fetal kidney length as a useful adjunct parameter for determination of gestational age

Introduction: Accurate gestational age assessment is important in obstetric care ultrasonography. Fetal kidney length is one of the emerging parameter in estimation of fetal gestational age in 3rd trimester. Objectives: Is to the ascertain the precision of ultrasonographic fetal kidney length measurement as a reliable parameter for determination of gestational age in 3rd trimester. Materials and Methods: Cross-sectional observational study was conducted on 152 antenatal women in the 3rd trimester. Gestational age was estimated by early fetal ultrasound measure and last menstrual period. Results: Mean kidney length showed a Pearson’s correlation coefficient of 0.907 and a determination coefficient of 0.822 with GA. The test was significant at P &lt; 0.05. Conclusions: This study confirms that the fetal kidney length measurement for estimating the gestational age accurately in the 3rd trimester.

1452-P: PDX1 and CKas Markers of Cell Maturation in the Human Pancreas

Regeneration of beta-cell mass is one of the fundamental problems in diabetology. Embryonic source of all pancreatic cell types is the epithelial cells of the primitive ducts. During pancreas development, epithelial progenitors differentiate in three directions, which is accompanied by changes in cell phenotype, including the expression of various types of cytokeratins, transcription factors, as well as hormones and some other antigens. The early markers of pancreatic epithelial progenitors are the homeodomain transcription factor Pdx 1 (pancreatic and duodenal homeobox 1) and an intermediate filament protein cytokeratin (CK19) . The aim of our work was to analyze the distribution of Pdx1 and CKduring endocrine pancreas development in humans. The study was performed on the pancreatic samples from 27 fetuses (gestational age 14-40 weeks) using double and triple immunohistochemistry with antibodies to Pdx1, CK19, and insulin or glucagon. During human prenatal development, the co-expression of CKand Pdx1 was detected in several cell types. Firstly, it was observed in the epithelial cells of the pancreatic ducts. During the branching of pancreatic ducts, CKexpression decreased in outgrows, while the Pdx1 expression was lowered in large ducts. Secondly, co-expression of CKand Pdx1 was detected in endocrine cells (mainly in alpha) . However, the intensity of the reaction to both markers in these cells was low. Phenotype of beta cells was Pdx1+/ CK19−. At the same time, during development, some cells with an intense reaction to CKand Pdx1 were detected in the forming islets. Apparently, an intense reaction to CK19/Pdx1 may characterized low-differentiated (progenitor) cells that are present in the epithelium of ducts and in the forming islets during the development of the human pancreas. Disclosure A.Proshchina: n/a. Y.Krivova: None. D.Otlyga: None. S.Saveliev: None.

Maternal diabetes independent of BMI is associated with altered accretion of adipose tissue in large for gestational age fetuses.

AimTo analyse the effects of maternal diabetes mellitus (DM) and body mass Index (BMI) on central and peripheral fat accretion of large for gestational age (LGA) offspring.MethodsThis retrospective study included LGA fetuses (n = 595) with ultrasound scans at early (19.23 ± 0.68 weeks), mid (28.98 ± 1.62 weeks) and late (36.20 ± 1.59 weeks) stages of adipogenesis and measured abdominal (AFT) and mid-thigh (TFT) fat as surrogates for central and peripheral adiposity. Women were categorised according to BMI and DM status [pre-gestational (P-DM; n = 59), insulin managed (I-GDM; n = 132) and diet managed gestational diabetes (D-GDM; n = 29)]. Analysis of variance and linear regressions were applied.ResultsAFT and TFT did not differ significantly between BMI categories (normal, overweight and obese). In contrast, AFT was significantly higher in pregnancies affected by D-GDM compared to non-DM pregnancies from mid stage (0.44 mm difference, p = 0.002) and for all DM categories in late stage of adipogenesis (≥ 0.49 mm difference, p < 0.008). Late stage TFT accretion was higher than controls for P-DM and I-GDM but not for D-GDM (0.67 mm difference, p < 0.001; 0.49 mm difference, p = 0.001, 0.56 mm difference, p = 0.22 respectively). In comparison to the early non-DM group with an AFT to TFT ratio of 1.07, the I-GDM group ratio was 1.25 (p < 0.001), which normalised by 28 weeks becoming similar to control ratios.ConclusionsDM, independent of BMI, was associated with higher abdominal and mid-thigh fat accretion in fetuses. Use of insulin improved central to peripheral fat ratios in fetuses of GDM mothers.

Determination of Fetal Gestational Age in Singleton Pregnancies: Accuracy of Ultrasonographic Placenta Thickness and Volume at a Nigerian Tertiary Hospital

Determination of Fetal Gestational Age in Singleton Pregnancies: Accuracy of Ultrasonographic Placenta Thickness and Volume at a Nigerian Tertiary Hospital

Fetal growth and gestational age improve outcome predictions in neonatal heart surgery

ObjectiveCurrent risk adjustment models for congenital heart surgery do not fully incorporate multiple factors unique to neonates such as granular gestational age (GA) and birth weight (BW) z score data. This study sought to develop a Neonatal Risk Adjustment Model for congenital heart surgery to address these deficiencies. MethodsCohort study of neonates undergoing cardiothoracic surgery during the neonatal period captured in the Pediatric Cardiac Critical Care Consortium database between 2014 and 2020. Candidate predictors were included in the model if they were associated with mortality in the univariate analyses. GA and BW z score were both added as multicategory variables. Mortality probabilities were predicted for different GA and BW z scores while keeping all other variables at their mean value. ResultsThe C statistic for the mortality model was 0.8097 (95% confidence interval, 0.7942-0.8255) with excellent calibration. Mortality prediction for a neonate at 40 weeks GA and a BW z score 0 to 1 was 3.5% versus 9.8% for the same neonate at 37 weeks GA and a BW z score −2 to −1. For preterm infants the mortality prediction at 34 to 36 weeks with a BW z score 0 to 1 was 10.6%, whereas it was 36.1% for the same infant at <32 weeks with a BW z score of −2 to −1. ConclusionsThis Neonatal Risk Adjustment Model incorporates more granular data on GA and adds the novel risk factor BW z score. These 2 factors refine mortality predictions compared with traditional risk models. It may be used to compare outcomes across centers for the neonatal population.

The importance of the cerebroplacental ratio for the prognosis of neonatal outcome in AGA fetuses

PurposeAs a Doppler sonographic parameter, the cerebroplacental ratio (CPR) provides information about fetal hemodynamics and the redistribution of fetal blood volume in response to a metabolic change. The present study was undertaken to determine the extent to which CPR can be used as a valid parameter in routine obstetric assessment. We investigated whether CPR can be used to assess the neonatal outcome in appropriate for gestational age (AGA) fetuses and its association with secondary cesarean section due to fetal distress.MethodsIn this retrospective analysis 1739 pregnant women were admitted to the University Women‘s Clinic Magdeburg, Germany, between January 2016 and December 2017. Of them, 710 AGA fetuses were eligible for analysis. SGA fetuses with an estimated fetal weight < 10th percentile were excluded from the study. The AGA fetuses were divided in two groups based on the CPR: 669 fetuses showed a normal CPR ≥ 1.08; 41 fetuses showed a decreased CPR < 1.08.ResultsIn our study cohort decreased CPR in AGA fetuses was associated with threefold increased rate of cesarean sections due to fetal distress (p < 0.001). Our data suggested that low CPR is a reliable predictor of an impaired neonatal outcome in AGA fetuses in terms of a lower birth weight, transfer to neonatology, longer length of hospitalization, and the presence of severe morbidity.ConclusionDecreased CPR in AGA fetuses correlated with impaired neonatal outcome and secondary cesarean section due to fetal distress. The potential role of CPR for obstetric screening should be investigated in further studies.

COVID-19 & differential effects in twins: Insights from Placenta Pathology

IntroductionCOVID-19 has been associated with several adverse pregnancy outcomes, including perinatal loss. Differential effects of COVID-19 in a twin pregnancy may provide unique insights into virus-placental interactions. We present a case of perinatal loss of a female fetus with survival of the male co-twin in a pregnancy complicated by COVID-19 and premature delivery. MethodsViral detection methods recommended by the NICHD task force were used to identify SARS-CoV-2 and its viral receptors in the placentas and fetal tissue (Antoun et al., 2020) [1] ResultsCompared with the surviving twin, we found a more severe intervillous necrosis and a relatively low detection of ACE2 membranous expression in the syncytiotrophoblasts of the female twin that succumbed. DiscussionThe interactions of SARS-CoV-2 and ACE2 at the maternal fetal interface within the placenta may play a significant role in perinatal loss, and the effects of fetal sex and gestational age at time of infection need to be explored further.

Comparison of Fetal Biometry in Pregnancies with Anterior and Posterior Placental Locations

Since the invention of ultrasound, it has become the most popular and widespread method in obstetric care to establish fetal gestational age (GA), to monitor the growth and to predict the adverse pregnancy outcome. Nowadays, the information of placental details (location, size, volume, morphology) has become the greatest interest to the obstetrician. Assessment of in utero placenta by ultrasound along with other fetal biometry can provide more details regarding current pregnancy. The importance of examining the placenta cannot be overlooked as it plays the central role in supporting fetal growth, also maternal wellbeing. Whether there are any differences among the different physiological positions of the placenta are still smoky. In this study, we compared anterior and posterior placental pregnancy of 13 -40 weeks intending to determine whether there are any variations in fetal biometry between these two and we also compared maternal age between two placental positions to find out if there is any relation of placental attachment variation with maternal age. A total of 427 pregnancies were in the range of 13-40 weeks. Among them, in 40 pregnancies, the placentas were formed in locations other than anterior or posterior (low lying position or completely fundal or lateral position). We excluded those pregnancies. Only anterior and posterior placental pregnancies were analyzed in this study. As a result of the above exclusion criteria, we could include a total of 387 pregnancies in our final analysis among them 188 pregnancies were anterior placental, and 199 pregnancies were posterior placental. As the anterior and posterior placental locations are more common in our study group, we compared fetal presentation, fetal HR, fetal biometry (BPD, FL, EFW), AFI, maternal age between the pregnancies of these two placental locations. In the case of anterior placental pregnancies, the fetal presentations were cephalic in 78.7% cases, breach in 11.2% cases, unstable in 9.04% cases and transverse in 1.06% cases. On the other hand, in pregnancies of posterior placenta fetal presentations were cephalic in 82.4% cases, breech in 14.6% cases, unstable in 2.5% cases and transverse in 0.5% cases. In this observational study, several parameters (BPD, FL, EFW, AFI, fetal presentation, HR, and maternal age) were compared between pregnancies of anterior placenta and pregnancies of the posterior placenta. In the case of all the parameters, no significant differences were found between the two groups except in some measurements of a few gestational age groups. But overall, when the measurements of 13-40 weeks of each parameter in two different groups were compared, there were no significant differences between them. In summary, this study results suggest that advanced maternal age is not one of the predisposing factors of having either anterior or posterior placenta and there is no significant difference in fetal presentation, fetal biometry, or fetal biophysical profile between anterior or posterior placental pregnancy.

Effect of Postoperative Intravenous Ketorolac Administration on Postoperative Urine Output After Cesarean Delivery [A169

INTRODUCTION: To determine if intravenous ketorolac administration has an effect on the postoperative urine output after cesarean delivery. METHODS: We conducted a retrospective cohort study of women who delivered at Staten Island University Hospital from January 1 to June 30, 2021. During this timeframe, there were 236 cesarean deliveries. Exclusion criteria included intrauterine fetal demise (IUFD) and gestational age at delivery. Operative records and PACU records were utilized to determine intraoperative urine output, intraoperative estimated blood loss (EBL), intraoperative intravenous fluid (IVF) administration, postoperative urine output, and whether or not ketorolac was administered (dependent on surgeon preference). All patients received IVF postoperatively at 125 mL/hour. Urine output was measured for the first three hours postoperatively and was considered adequate if &gt;0.5 mL/kg/hour. We conducted analyses using multiple linear regressions and chi-square tests, where P&lt;.05 was considered statistically significant. The study was institutional review board‒-approved. RESULTS: After controlling for potential cofounders (operative EBL, amount of Pitocin, and intraoperative IVF), a linear regression showed the effect of IV ketorolac was significant (P&lt;.001), with a mean decreased postoperative urine output of 53 mL/hour compared to patients who did not receive ketorolac. CONCLUSION: As postoperative ketorolac administration after cesarean delivery is associated with clinically significant decreased urine output and is contraindicated in patients who are at high risk of bleeding, alternative modalities for postoperative pain management should be considered.

Acyl-CoA binding protein (ACBP) is highly expressed in the developing human kidney.

Acyl-CoA-binding protein (ACBP), also known as diazepam binding inhibitor (DBI), is a small phylogenetically conserved protein. This ancestral peptide is multifunctional, performing intracellular activities as ACBP protein or extracellular roles as DBI. Several studies showed its endless facets, including a relevant activity as appetite stimulator and as anabolic factor. High levels of ACBP have been described in erythrocytes, liver, kidney, and gut cells. The aim of this study was to analyze, at immunohistochemical level, the expression of ACBP in fetal human tissues during development, focusing on the developing kidney. Immunohistochemistry for ACBP was performed on 30 human fetal kidneys, from 15 fetuses of gestational age ranging from 13 to 19 weeks. At autopsy, all kidney samples were 10% formalin-fixed, routinely processed and paraffin-embedded. Five micron-thick paraffin sections were stained with Hematoxylin and Eosin and PAS stain for a morphological examination. ACBP was detected in all 30 kidneys analyzed in this study. No significant changes in ACBP expression were observed at different gestational ages. Immunostaining for ACBP was restricted to the epithelium covering the renal pelvis, the papillae, the collecting tubules, and the proximal and distal tubules. On the other hand, medullary regions and in the metanephric mesenchymal stem/progenitor cells did not show any reactivity for ACBP. According to our findings, ACBP should be considered as a new player in the complex field of human nephrogenesis, given that it was detected in all fetal kidneys immunostained. Its preferential localization in the renal structures derived from the Wolf duct, such as pelvis epithelium and collecting ducts, suggests a major role for ACBP in the induction of the metanephric mesenchymal cells toward the differentiation into glomerular structures. ACBP expression in proximal and distal tubules, two structures originating from the metanephric mesenchyme, indicates a further role of this protein in nephron development. In conclusion, ACBP should be added to the multiple molecules involved in human nephrogenesis.

Optimal delivery time for patients with diet-controlled gestational diabetes mellitus: a single-center real-world study

BackgroundTo determine the optimal delivery time for women with diet-controlled gestational diabetes mellitus by comparing differences in adverse maternal–fetal outcome and cesarean section rates.MethodsThis real-world retrospective study included 1,050 patients with diet-controlled gestational diabetes mellitus who delivered at 35–42 weeks’ gestation. Data on patient characteristics, maternal–fetal outcomes, and cesarean section rate based on fetal gestational age were collected and analyzed. Differences between deliveries with and without iatrogenic intervention were also analyzed.ResultsThe cesarean section rate at ≥ 41 weeks’ gestation was significantly higher than that at 39–39 + 6 weeks (56% vs. 39%, p = 0.031). There were no significant differences in multiple adverse maternal or neonatal outcomes at delivery before and after 39 weeks. Vaginal delivery rates were increased significantly at 39–39 + 6 weeks due to iatrogenic intervention (p = 0.005) and 40–40 + 6 weeks (p = 0.003) in patients without and with spontaneous uterine contractions, respectively.ConclusionsIt’s recommended that optimal delivery time for patients with diet-controlled gestational diabetes mellitus should be between 39- and 40 + 6 weeks’ gestation. Patients who have Bishop scores higher than 4 can undergo iatrogenic intervention at 39–39 + 6 weeks. However iatrogenic interventions are not recommended for patients with low Bishop scores.

Umbilical Venous Volume Flow in Late-Onset Fetal Growth Restriction.

Umbilical vein flow (UVF) is reduced in fetal growth restriction (FGR). We compared absolute and size-adjusted UVF (estimated fetal weight [EFW] and abdominal circumference [AC]) and rates of abnormal UVF parameters (<10th percentile) among FGR fetuses meeting Delphi criteria (FGR-D) against small for gestational age (SGA) fetuses and appropriate for gestational age (AGA) controls. Absolute UVF, UVF/EFW, and UVF/AC were compared between 73 FGR pregnancies (35 FGR-D, 38 SGA) and 108 AGA controls. Rates of abnormal UVF were compared to abnormal umbilical artery pulsatility index (UAPI). Independent samples t-tests, Mann-Whitney U, odds ratio (OR), chi-squared, and Fisher's exact tests were used as appropriate. Mean absolute UVF was significantly decreased in FGR-D compared to AGA (P=.0147), but not between SGA and AGA fetuses. The incidence of both abnormal absolute UVF and UVF/AC values (<10th centile) was higher among late-onset FGR fetuses versus AGA fetuses (UVF: OR 2.7, confidence interval [CI] 1.37-5.4; UVF/AC: OR 2.73, CI 1.37-5.4). UVF was more frequently abnormal than UAPI and in only two fetuses were both Doppler values abnormal. Absolute UVF is altered in late-onset FGR, and most pronounced among FGR-D. UVF may provide additional insight into fetal compromise in those affected by growth restriction.

Evaluation of predictive value of anterior cerebral artery to umbilical artery Pulsatility Index Ratio and its comparison with medial cerebral artery to umbilical artery Pulsatility Index Ratio for FGR and appropriate for gestational age (AGA) fetuses

Evaluation of predictive value of anterior cerebral artery to umbilical artery Pulsatility Index Ratio and its comparison with medial cerebral artery to umbilical artery Pulsatility Index Ratio for FGR and appropriate for gestational age (AGA) fetuses

Ultrasonographic Evaluation of Fetal Sacral Length: Correlation with Gestational Age

Introduction: Obstetricians need an accurate estimate of gestational age to decide when to terminate the pregnancy and how to deliver the baby. When unreliable menstrual history cannot be used to determine gestational age, ultrasonography comes in handy. Ultrasonography has been used to determine gestational age using a variety of parameters. However, all of these parameters are only reliable in the first and second trimesters of pregnancy. They become less reliable as the pregnancy progresses, due to a variety of factors, with a maximum variability of about 3 to 3.5 weeks in the third trimester. Methods: A total of 200 pregnant women participated in this prospective observational study at the Department of Radiology and Imaging, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine, and Metabolic Disorders. The research was carried out between January 2001 and December 2002. Result: The participants' average age was 24.54 years. Only 3% of the participants were in the oldest age range of 36-40 years, with 38 percent of the participants being between the ages of 21 and 25. The average height of the participants was 150-154 cm in 52 percent of the cases. The mean SD height and weight were 152.40±3.44 cm and 54.80±4.45 kg, respectively. There is a strong positive relationship between fetal sacral length and gestational age, according to BPD and FL. The relationship between gestational age and fetal sacral length was demonstrated to be statistically significant. There was no statistically significant relationship between fetal sacral length and maternal height. Conclusion: Fetal sacral length is well related to gestational age. If sacral length is measured accurately with a high-resolution ultrasound scanner, it can be used reliably as an additional parameter throughout pregnancy in conjunction with other established parameters.