Determination of Gestational Age using Crown-Rump Length and its Associated Maternal Correlates in Igbos Living in Nnewi: An Ultrasound Study.
DOI:
https://doi.org/10.47941/ijhmnp.1735Keywords:
Gestational Age, Crown-Rump Length, Maternal Correlates, Igbos Living In Nnewi, Ultrasound StudyAbstract
Purpose: The objective was to determine the accuracy of gestational age measured by CRL in fetuses of black women and also to identify the maternal factors affecting this accuracy in determining the gestational age by CRL measurement in fetuses of black women.
Methodology: This prospective cross-sectional study was conducted in Life and Trinity Specialist hospitals both in Nnewi, South-East, Nigeria. The gestational ages of the fetuses by CRL were determined using Siemens 2D ultrasound scan within 14 weeks and the accuracy compared with the gestational ages obtained from the Last Menstrual Period (LMP). Factors affecting the accuracy of CRL in determining the gestational age in women like the maternal heights and ages were measured. The ultrasound scan was done by a consultant in the department of Obstetrics. Analysis was done using SPSS Package version [20]. Regression analysis was used to compare dependent ad independent variables. Paired t-test was carried out on gestation period by LMP and gestation period by CRL to know if the mean difference between the gestation period by LMP and gestation period by CRL is significant. Multiple correlation analysis was used to ascertain the degree of relationship between maternal weight and age and gestational age by LMP and CRL.
Findings: The result showed that two hundred and sixty-five women met the inclusion criteria but two were lost to follow up and two hundred and sixty-three were used finally for analysis. The accuracy of ultrasound scan in estimating the gestational age using CRL is within one week in majority of the cases. Maternal height, weight and age are poorly correlated to age of the fetus using the CRL. The fetuses of black women showed a marginal increase in length at gestational age below eight weeks but afterwards this difference is not pronounced. In conclusion, the accuracy of CRL in determining the gestational age is within one week in majority of cases. The maternal height and age are poorly correlated to the CRL of the fetus and thus to the gestational age.
Unique Contributor to Theory, Policy and Practice: Ultrasound scan incorporated with growth chart for fetuses of white women can be equally used to ascertain the gestational ages of fetuses of black women with insignificant difference
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References
Fleming JE, Robinson HP, 1975. A critical evaluation of sonar "crown-rump length" measurements. British Journal of Obstetrics and Gynaecology; 82:702-10.
Niek exalto and Eric AP Steegers BJOG.2019 Feb;126 (3):310.
Hadlock FP, Kanon DJ, Lindsey JV, Shah YP, 1992. Fetal crown-rump length: re-evaluation of relation to menstrual age (5- 18 weeks) with high resolution, real-time ultrasound. Radiology; 182:501.
Drumm JE, 1977: The prediction of delivery date by ultrasound measurement of fetal crown-rump length. British Journal Obstetrics and Gynaecology 84:1.
Lasser DM, Peisner DB, Timor-tritsch I, Vollebergh J, 1993. First trimester fetal biometry using transvaginal sonography. Ultrasound Obstetrics and Gynecology; 3:104.
Bovicelli L,Orsini LF, Rizzo et al, 1981. Estimation of gestational age during the first trimester by real-time measurement of fetal crown-rump length and biparietal diameter. J Clin Ultrasound; 9:71.
Maha M. Hassan, Emad M. Ibrahim, Ameer A. Abdallah Ayman M. Yousif. A logistic model of early pregnancy ultrasound measurements and prediction of first-trimester outcome MJMR, vol.33, no2, 2022, pages (197- 212).
Rossavik IK, Torjusen GO, Gibbons WE. Conceptual age and Ultrasound measurements of gestational sac and crown-rump length in invitro fertilization pregnancies. Fertil Steril 1988; 49:1012.
Alice Self, Lama Daher, Michael Schlussel, Nia Roberts, Christos Loannou and Aris T. Papageorghiou. Second and third trimester estimation of gestational age using ultrasound or maternal symphysis-fundal height measurements: A systematic review. BJOG. 2022 Aug; 129 (9): 1447-1458.
Salim Daya, 1993. Accuracy of gestational age estimation by means of fetal crown-rump length measurement. Am J Obstet Gynecol. 1993;168: 903-8.
David A Savitz, James W Terry Jr, Anna Maria Siega-RizAmy H Herring. Comparison of pregnancy dating by last menstrual period, ultrasound scanning and their combination.Am J Obstet Gynecol. 2002 Dec; 187 (6):1660-6.
Bhide A, Sairam et al, Sankararan S,2009 . relationship of inter-twin crown-rump length discrepancy to chorionicity, fetal demise and birth weight discordance. Ultrasound Obstetrics and Gynecology; 34:131.
Dias T, Mahsud-Dornan S, Thilaganathan B. First trimester ultrasound dating of twin pregnancy. Are singleton charts reliable? BJOG 2010; 117:979-984.
Grisolia G, Milano K, Pilu 1993. Biometry of early pregnancy with transvaginal sonography. Ultrasound Obstetrics and Gynecology; 3:403.
Kimberly B, Kenneth IL. Guideline No 388- Determination of Gestational Age by Ultrasound. JOGC 2019 Oct; 41 (10):1497-1507.
Bell ET, Loraine JA, 1965: Time of ovulation in relation to cycle length. Lancet1:1029.
Queenam JT, 1971: amniotic fluid analysis. Clinical Obstetrics and Gynecology 14:505.
Mogishi KS, 1980: Prediction and detection of ovulation. Fertility Sterility 34:89.
Rossavik IK, Torjusen GO, Gibbons WE. Conceptual age and Ultrasound measurements of gestational sac and crown-rump length in invitro fertilization pregnancies. Fertil Steril 1988; 49:1012.
Tunon K., Elk-nes S.H. Grottum P., Von During V.,Kahn J.A., 2000: Gestational age in pregnancies conceived after in-vitro fertilization: A comparison between age assessed from oocyte retrieval, crown-rump length and biparietal diameter. Ultrasound Obstet Gynecol 2000; 15: 41-46.
Yin Xu, Meng Ni, Qiangian Zhang, Jiuru Zhao, Zheng Tang, Zhiwei Liu. Correlation between crown-rump length in first trimester of pregnancy and neonatal outcomes. BMC Pediatrics 22, Article number: 386 (2022)
Ohuma E.O., Papageorhiou A.T., Villar J., Altman D. Estimation of gestational age in early pregnancy from crown-rump length when gestational age range is truncated: The case study of the INTERGROWTH-21ST project. December 2013. BMC Medical Research Methodology; 13(1):151.
Russell F., `Villar J., Dashti A.,Ismail C.L, Staine-Urias E., Ohuma E.O. Achieving accurate estimates of fetal gestational age and personalized predictions of fetal growth based on data from an internationational prospective cohort study: a population-based machine learning study. The Lancet digital health 2 (7):E368-E375,July 2020.
Cowchock FS, 1976: Use of alpha-fetoprotein in prenatal diagnosis. Clinical Obstetrics and Gynaecology 19:871.
Liley AN, 1961: liquor amnii in the management of pregnancy complicated by rhesus sensitization. American Journal of Obstetrics and Gynecology 82:1359.
Queenam JT, 1971: amniotic fluid analysis. Clinical Obstetrics and Gynecology 14:505.
Verburg B.O., Steegers E.A.P., De Ridder M., Snijder R.J.M., Smith E. Hofman A, Moll H.A., Jaddoe V.W.V., Witteman J.C.M. New charts for ultrasound dating of pregnanacy and assessment of fetal growth: longitudinal data from a population-based cohort study. Ultrasound Obstet Gynecol 2008 Apr;31(4):388"”96.
Stirnemann J., Massoud M., Fries N., Dumont C., Haddad G.,Bessis R., Dhombres F., SalomonL. J. 16 June, 2021.Crown-rump measurement: a new age for first-trimester ultrasound? Ultrasound in Obstetrics and Gynaecology; 58(3): 345-346.
Goldenberg RL, Nelson K, 1975: Iatrogenic respiratory distress syndrome. American Journal of Obstetrics and Gynecology 123: 617.
Hackmond R., Cliffford L., Burwick R., Rodriguues N., Farine D., Berger H; September, 2017. Do early fetal measurements and nuchal translucency correlate with term birth weight? Journal of Obstetrics and Gynaecology, Canada; 39(9):750-756.
Bottomley C, Annelen D, Faizah M, Aris T, Papageorghiou, Kirk E, Pexsters A, De Moor B, Timmerman, Bourne T. Human reprod (2009), 24(2): 284-290.
Adinma ED, Adinma JI, (2011) . Impact of Reproductive Health on Socio-economic Development: A Case Study of Nigeria. African Journal of Reproductive Health; 15(1):7-12.
Salomon Lj, Cavicchioni O, Bernard JP. Growth discrepancy in twins in the first trimester of pregnancy. Obstet Gynecol Ultrasound 2005; 26: 512-516.
Grunewald C, Kublickas M, Saltvedt S, Sladkevicus P, Valetin L, (2005). Ultrasound dating at 12- 14 weeks of gestation. A prospective cross-validation of established dating formulae in in-vitro fertilized pregnancies. Ultrasound in Obstetrics and Gynecology; 26(5):504-511.
McLennan A., Mogra F., Murphy K., Schluter P., Hyett J. October, 2013. Assessment of crown-rump measurement variability. Ultrasound in Obstetrics and Gynecology; 42(s1):102- 102.
Sahota D.S., Leung T.Y., Leung T.N., Chan O.K., Lau T.K. December, 2008. Fetal crown-rump and estimation of gestational age in ethnic Chinese population. Ultrasound in Obstetrics and Gynecology; 33(2): 157-160.
Patel S., Sarkar A., Pushpalatha K. Setember, 2022. A prospective study of correlation of first trimester crown-rump length with birth weight. Cureus;14(9):e28781
Tan C., Ellewela C.N., Sandhu S.S., Melamed N., Librach C.L., Aviram A. A new formula for estimating gestational age by crown-rump length. Am J Obstet Gynecol MFM. 2023 May 27;101035
Amita A. Mahendru, Charlotte S. Wilhelm-Benartzi, Ian B. Wilkinson, Carmel Mceniery, Sarah Jojnson and Christoph Lees. Gestational age assignment based on last menstrual period, first trimester crown-rump length, ovulation and implantation timing: Arch Gynecol Obstet. 2016;294(4):867-876.
Khandelwal M., Kaigh C., Safronova E., Gaughan J. Accurate Gestational Dating at 12-14 Weeks: Crown-Rump Length Versus Composite Biometry[29S]. May 2019. Obstetrics and Gynecology; 133(1)210S.
American College of Obstetricians and Gynecologist's. ACOG practice bulletin no 101; ultrasonography in pregnancy. Obstet Gynecol 2009;113: 451- 61.
American College of Obstetricians and Gynaecologists. ACOG practic210Se bulletin: Committee on obstetric practice; American Institute of Ultrasonography in Medicine, number 700; 2017.
Albony-Llaty M, Thiebaugeorges O, Goua V, Magnin G, Schweittzer M, Forhan A, Lelong N, Slama R, Charles MA, Kaninski M and the EDEN mother-child cohort study group (2004). Influence of fetal and parental factors on intrauterine growth measurements: results of EDEN mother-child cohort.
Mook-Kanamori DO, Steegers EA, Eilers PH, Raat H, Hofman A, Jadoe VW (2010). Risk factors and outcomes associated with first trimester fetal growth restrictions. JAMA;303:527-534.
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