IJAR.2016.472

Type of Article:  Original Research

Volume 5; Issue 1 (January 2017)

Page No.: 3342-3349

DOI: https://dx.doi.org/10.16965/ijar.2016.472

THE STUDY OF RELATION BETWEEN THE GESTATIONAL AGE OF HUMAN FETUSES AND THE DIAPHYSEAL LENGTH OF FEMUR USING ULTRASONOGRAPHY

Chaithra Rao B R *1, Sunkeswari Sreepadma, 2 R N Kalghatgi 3.

*1 Assistant Professor, Department of Anatomy, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.

2 Associate Professor, Department of Anatomy, SDM College of Medical Sciences & Hospital, Dharwad, Karnataka, India.

3 Professor, Department of Anatomy, SDM College of Medical Sciences & Hospital, Dharwad, Karnataka,  India.

Corresponding Author: Dr Chaithra Rao B R Assistant Professor, Department of Anatomy,  Sapthagiri Institute of Medical Sciences and Research Centre, No 15, chikkasandra, Hesarghatta main road, Bangalore- 560090, Karnataka. India. Ph- +919916667709 Fax- 080283933404

E-Mail: chaithra.rao5@gmail.com

ABSTRACT

Background and Objectives: Presently the most effective way to date pregnancy is by the use of ultrasound. The diaphyseal length of femur can be used as an additional parameter to estimate gestational age. The objective is to evaluate of the diaphyseal length of femur as a parameter to estimate the gestational age of the fetus at the time of examination.

Materials and Methods: It is a Prospective cross sectional study done on 152 antenatal women. Antenatal women of all gestational age from 15 to 40 weeks of gestation from the District of Dharwad, age ranging from 20 to 30 yrs were included. Subjects with maternal disease known to affect normal fetal growth such as chronic hypertension, gestational diabetes mellitus, anemia, hypothyroidism, etc. and history of recurrent miscarriages and of chronic medications, multiple gestations or other complications such as fetal growth restriction, preeclampsia, pregnancy induced hypertension, placenta previa, or major fetal abnormalities were excluded.  The diaphyseal length of femur was measured by an experienced Ultrasonographer in a standardized manner. The study establishes the relationship of the diaphyseal length of femur in centimeters, with the advancing gestational age in weeks. We obtained correlation of the diaphyseal lengths of femur with the gestational age from 15 to 40 weeks.

Results: It was observed that the diaphyseal length of femur gradually increased from 15 weeks to 40 weeks of gestation. Normograms of diaphyseal lengths of femur can be constructed by the formula derived by this study for this particular geographical area. These normograms can be used to determine whether a given diaphyseal length of femur is normal or abnormal for a particular gestational age.

Conclusion:    The relationship between the diaphyseal length of femur and the gestational age is linear and direct. The measurement of the diaphyseal lengths of femur (in cm) can be an important additional parameter for estimating gestational age along with other parameters.

Key words: Down’s syndrome; Femur; Fetal growth retardation; Fetus; Gestational age; Ultrasonography.

REFERENCES

  1. Shehzad K, Ali M, Zaid S. Fetal Biometry. Pak J Med Sci 2006;22(4):503-8.
  2. Silva LM, Jansen PW, Steegers EAP, Jaddoe VWV, Arends LR, Tiemeier H et al. Mother’s educational level and fetal growth: the genesis of health inequalities. Int. J. Epidemiol 2010;39(5):1250-61.
  3. Johnson TRB, Gregory KD, Niebyl JR. Preconception and Prenatal Care: Part of continuum. In: Gabbe SG, Niebyl JR, Simpson JL, editors. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia: Churchill Livingstone Elsevier; 2007. p. 111-37.
  4. Khan Z, Faruqi NA. Determination of Gestational Age of Human Foetuses From Diaphyseal Lengths Of Long Bones – A Radiological Study.Anat.Soc. India; 2006;55(1): 67-71.
  5. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CV. Fetal Imaging. In: Williams Obstetrics. 23th ed. USA:The McGraw Hill Companies; 2010. p. 349-71.
  6. Rice KJ, Ballas J, Lai E, Hartney C, Jones MC, Pretorius DH. Diagnosis of fetal limb abnormalities before 15 weeks: cause for concern. J Ultrasound Med 2011;30(7):1009-19.
  7. Exacoustos C, Rosati P, Rizzo G, Arduini D. Ultrasound measurements of fetal limb bones. Ultrasound Obstet Gynecol 1991;1(5):325-30.
  8. Malhotra N, Suresh S. Physics of Ultrasound. In: Malhotra N, editor. Ultrasound in obstetrics and gynaecology. 3rd ed. New Delhi: Jaypee Brothers Medical publishers; 2001. 10-6.
  9. Gupta K. Measurement of foetal parameters. In: Malhotra N, editor. Ultrasound in obstetrics and gynaecology. 3rd ed. New Delhi: Jaypee Brothers Medical publishers; 2001. p. 92-8.
  10. Rosati P, Guariglia L, Capelli G. A new mathematical formula for predicting long bone length in early pregnancy. Ultrasound Obstet Gynecol  2002;19(2):184-9.
  11. Hadlock FP, Harrist RB, Deter RL, Park SK. Fetal femur length as a predictor of menstrual age: sonographically measured. AJR Am J Roentgenol  1982;138(5):875-8.
  12. Gabrielli S, Falco P, Pilu G, Perolo A, Milano V, Bovicelli L. Can transvaginal fetal biometry be considered a useful tool for early detection of skeletal dysplasias in high-risk patients? Ultrasound Obstet Gynecol 1999;13(2):107-11.
  13. Zorzoli A, Kustermann A, Caravelli E, Corso FE, Fogliani R, Aimi G et al. Measurements of fetal limb bones in early pregnancy. Ultrasound Obstet Gynecol 1994;4(1):29-33.
  14. Salomon LJ, Duyme M, Crequat J, Brodaty G, Talmant C, Fries N et al. French fetal biometry: reference equations and comparison with other charts. Ultrasound Obstet Gynecol 2006;28(2):193-8.
  15. Leung TN, Pang MW, Daljit SS, Leung TY, Poon CF, Wong SM et al. Fetal biometry in ethnic Chinese: biparietal diameter, head circumference, abdominal circumference and femur length. Ultrasound Obstet Gynecol  2008;31(3):321-7.
  16. Kurmanavicius J, Wright EM, Royston P, Zimmermann R, Huch R, Huch A et al. Fetal ultrasound biometry: Abdomen and femur length reference values. Br J Obstet Gynaecol 1999;106(2):136-43.
  17. Merialdi M, Caulfield LE, Zavaleta N, Figueroa A, Costigan KA, Dominici F et al. Fetal growth in Peru: comparisons with international fetal size charts and implications for fetal growth assessment. Ultrasound Obstet Gynecol 2005;26(2):123-8.
  18. Rosati P, Guariglia L. Trans-vaginal fetal biometry in early pregnancy. Early Hum Dev 1997;49(2):91-6.
  19. Sananes N, Guigue V, Kohler M, Bouffet N, Cancellier M, Hornecker F et al. Use of Z-scores to select a fetal biometric reference curve. Ultrasound Obstet Gynecol  2009;34(4):404-9.
  20. Verburg BO, Steegers EA, De Ridder M, Snijders RJ, Smith E, Hofman A et al. New charts for ultrasound dating of pregnancy and assessment of fetal growth: longitudinal data from a population-based cohort study. Ultrasound Obstet Gynecol  2008;31(4):388-96.

Cite this article: Chaithra Rao B R, Sunkeswari Sreepadma, R N Kalghatgi. THE STUDY OF RELATION BETWEEN THE GESTATIONAL AGE OF HUMAN FETUSES AND THE DIAPHYSEAL LENGTH OF FEMUR USING ULTRASONOGRAPHY. Int J Anat Res 2017;5(1):3342-3349. DOI: 10.16965/ijar.2016.472