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Background– Gestational diabetes mellitus (GDM) is defined as intolerance of glucose seen during pregnancy and is associated with fetal and maternal morbidity. The aim of our study was to measure various fetal sonographic parameters such as fetal biometry, fetal liver length (FLL), amniotic fluid deepest pocket (AFDP), placental thickness, inter ventricular (IV) septum thickness, Wharton's jelly area and fetal abdominal fat thickness (FAFT) during 21-24 weeks of gestation and comparison of these parameters between Gestational diabetic and normal pregnant women. Tot Methods: al patients selected in our study were 100 in number, of which 50 had GDM and 50 were normal pregnant women. Fetal standard biometry with additional parameters were measured on transabdominal scan from 21-24 weeks. Fetal sonographic measurements and patients characteristics were measured and compared between two groups. P-value was evaluated along with mean, standard deviation, mean difference and confidence interval Patient characteristics and standard fetal Results: biometric parameters were comparable except for femur length (FL), mean femur length was significantly greater in GDM women compared to normal pregnant women (39.20 ± 0.70 vs. 38.36 ± 1.20, p = 0.001). Mean values in GDM vs. normal pregnent women were, fetal placental thickness in mm ( 42.28 ± 2.09 vs. 33.24 ± 1.70, p = 0.001), amniotic fluid maximum vertical pocket in mm (54.96 ± 1.24 vs. 44.46 ± 1.06, p = 0.001), fetal abdomen fat layer thickness in mm (3.59 ± 0.17 vs. 3.46 ± 0.15, p = 0.001), inter ventricular septum thickness in mm (3.71 ± 0.13 vs. 3.63 ± 0.16, p = 0.001), fetal liver length in mm (36.48± 1.15 vs. 31.86 ± 0.90, p = 0.001), Wharton jelly area in mm2 (115.26 ± 1.96 vs. 109.34 ± 4.81, p = 0.001), Fetal sonographic Conclusion: parameters are significantly increased in GDM women compared to normal pregnant women even before 24 weeks. Measurements of these parameters in routine practice could be used to monitor fetal growth and hence can prevent fatal complications.
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Background: The objective of this study was to compare the fetal growth pattern in low risk Indian population with the INTERGROWTH-21 standards.Methods: Low risk women were enrolled at 10 to 20 weeks of gestation and followed up until delivery. An experienced operator performed abdominal ultrasound every 5±1 week and measured biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) of the fetus. Newborn anthropometric measurements were taken within 12 hours of childbirth.Results: A total of 126 healthy women, enrolled at mean gestation of 16.8±1.6 weeks, completed the follow up until delivery. None of the participants developed any major obstetric or medical morbidity. The study subjects showed lower mean z scores for BPD (-0.7±1.3), HC (-0.4±1.3) and AC (-0.4±1.3) but a higher mean z-score for FL (0.3±1.7) as compared to INTERGROWTH-21 standards. From 1st through 5th visit, the z scores for BPD and HC improved whereas declined for AC and FL.Conclusions: The fetal growth in non-affluent healthy Indian women had a lower fetal growth compared to INTERGROWTH-21 standards.
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Background: Accurate knowledge of gestational age of the foetus is essential for planning a timely and uneventful outcome. Biparietal diameter, head circumference, abdominal circumference and femur length reliably predict gestational age. The humerus length is not widely used as biometric parameter for determining the GA so the present study was done to estimate foetal gestational age by measuring humerus length between 18 to 36 weeks of normal singleton pregnancies and to compare humerus length with routine parameters.Methods: This was a hospital based descriptive cross-sectional study, 200 women with viable singleton pregnancy, with known LMP, between 18 weeks to 36 weeks of gestation were included. Various foetal measurements such as biparietal diameter, head circumference, abdominal circumference, femur length and humerus length were measured using electronic calipers on ultrasound. Data were statistically analyzed.Results: The mean humerus length at 18 weeks was 25.27±1.16 mm and at 36 weeks of gestation was 57.11±1.58 mm. Simple linear regression analysis shows a strongly significant linear relationship between humerus length and gestational age. Where, gestational age (weeks) Y= 0.5213 x humerus length (X) + 4.905; with high degree of correlation coefficient (R2 =0.9785 and P≤0.0001). When Compared with BPD, HC, AC and FL, humerus length also shows a linear correlation.Conclusions: The measurement of the humerus length can be an important additional parameter for estimating gestational age along with other parameters and can be used to predict the gestational age of fetuses in special circumstances.
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Introduction: Stature estimation by analyzing skeletalremains or body parts is an essential part of humanidentification. One critical role of stature estimation todaylies in the forensic identification of crime victims andmissing persons. Femur, being the longest and strongest bonein the body, plays a crucial role while estimating stature ofan individual. In this study, we tested a new approach topredict the stature of a person by radiologically measuringthe femur length.Material and methods: Our study was conducted on 100South Indian subjects (50 males and 50 females) with an aimof obtaining regression formulae for estimation of stature ofmales and females, from maximum femur length and anotherindividual sample consisting of 20 male and 20 femaleparticipants belonging to the same criteria as the preliminarysubject group was used for validating the obtained equations.Results: It was observed that femur length showedstatistically significant correlation with stature in both thegroups (p=0.0001). Regression equations specific togeographical (South-Indian) population were statisticallyanalyzed for femur lengths in males (r=0.880) and females(r=0.862) and significantly proved reliable in estimatingthe living stature of an individual.Conclusion: In our study, the mean stature value of maleswas higher than that of females contributing to theinference that males are generally taller than females.
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Introduction: Accurate estimation of Gestational age is of great value in proper obstetric care and interventionduring pregnancy. Ultrasound has evolved as a reliable method for accurate measurement of gestational age bymeasuring various fetal biometric features like Crown Rump Length (CRL), Biparietal Diameter (BPD), Femurlength (FL), Abdominal Circumference (AC), Head Circumference (HC), Trans Cerebellar Diameter (TCD) etc. Femurbeing the longest bone in fetus, least movable and easily imagable from second trimester to delivery, can bemeasured for estimation of gestational age. The present study was performed to evaluate femur length in secondand third trimester by ultrasonography, assess gestational age from measurement of Femur Length (FL) anddetermine the accuracy of gestational age assessed by ultrasonography with gestational age assessed by LMPmethod in local population of Gujarat.Materials and Methods: Cross sectional study of total of 200 pregnant women, 100 second trimester and 100third trimester, between 13 and 40 weeks of gestational age attending the department of radiology at P.D.U.Medical college, Rajkot for a fetal ultrasound scan was done. Femur length (FL) was measured; Gestational agewas measured by Hadlock’s method and Loughna P et al’s method; also gestational age was assessed from LMPof the women. The mean values of femur length and predictive accuracy of fetal femur length was analyzed andcompared with other studies.Results: Mean of FL increased progressively from 13-40 weeks of gestation. During both second and third trimesters,Hadlock’s formula and Loughna P’s method were equally accurate to assess the gestational age. But femur lengthwas more accurate in second trimester than in third trimester. There was discrepancy in values of femur lengthas compared to other studies.Conclusion: Like other studies the present study also found the need of fetal charts that were specific for individualpopulation and ethnic group to determine gestational age and EDD to enable the development of better clinicalguidelines for the present population.
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Background: Diabetes Mellitus is a complex disease with varying degree of systemic and oral complications. The prognosis is quite favorable if a disease is diagnosed in early stages. Since a large number of patients seek dental treatment routinely, screening procedures for early detection of subclinical cases can help in diagnosis of asymptomatic diabetes. Aim: The present study was undertaken to evaluate if gingival crevicular blood can be used for the estimation of blood glucose levels in periodontitis patients. Material and Methods: A prospective study was carried out comprising 150 patients Group A comprised of 75 subjects with gingivitis and group B comprised of 75 subjects with periodontitis. For gingival crevicular blood glucose (GCBG) level estimation, the blood was drawn onto the glucometer strip after gently probing the gingival sulcus and the readings were recorded. At the same time, blood Vijayendra Pandey, Akhilesh Chandra, Deepak Kumar, Anup Kumar Singh, Priyankesh, Alok Kumar Gupta. Estimation of gingival blood glucose using a sensitive self-monitoring device in periodontitis patients. IAIM, 2019; 6(6): 51-56. Page 52 was also collected from the index finger onto the glucometer strip for the capillary finger-prick blood glucose (CFBG) sample. Both the values were compared and statistical analysis of data was performed. Results: The mean GCBGL and CFBGL in group A was 98.43 mg/dl ± 18.62 and 103.48 mg/dl ± 13.90 respectively, while in group B it was 136.37 mg/dl ± 36.95 and 141.62 mg/dl ± 51.84, respectively. There was no statistically significant difference (p> 0.05) between the two values in both the groups. Conclusion: It can be concluded that GCBG levels are positively correlated with CFBG levels. Therefore, clearly indicating that gingival crevicular blood collected during diagnostic periodontal examination may be an excellent source of blood sample for glucometric analysis.
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Background & Objective: As the technology used in sonography has become more advanced accurate estimation of gestational age (GA) has become more demanding to plan treatments in pregnancy. Fetal kidney length (FKL) alone or its combination with other biometric parameters can be used in GA calculation more precisely in IInd&IIIrd trimester. Methodology: Two hundred three healthy pregnant females of IInd&IIIrd trimester were analyzed for GA calculation via FKL, Bi parietal diameter (BPD) and femur length (FL) using various lenear regression models. Results: Fetal kidney could be seen easily sonographically at 16thwk of gestation. FL was the most accurate single parameter (SE + 7.95 days) followed by FKL + 9.56days; BPD was the least accurate + 9.86 days. GA can be calculated most accurately by combining FKL with FL and BPD with SE + 7.12 days. Conclusion: FKL is easy to measure in IInd and IIIrd trimester and more accurate than BPD for GA estimation. So FKL could be used alone or easily incorporated into the model for dating pregnancies after 16th wk of gestation, in particular when measurements of BPD and FL are difficult.
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Introduction: Gestational age (GA) estimation is the most important part of obstetric practice and ultrasonic study plays an important role in its accurate estimation. Fetal femur length (FL) is one of the parameters used for estimation of GA along with biparietal diameter, head circumference and abdominal circumference (AC). Objective: This study is an attempt to correlate fetal FL with GA and to ascertain if fetal FL can be used as a parameter to calculate the GA in third trimester of pregnancy in Indian women with moderate accuracy. Findings have been compared with the work of sonologists from other countries. Material and methods: Pregnant women in the third trimester of pregnancy with single live fetus and having no other complication either in mother or fetus, were selected for the study, fetal FL along with other parameters was measured. The results were analyzed for accuracy in estimation of GA by FL and were compared with findings of other workers. Result: GA estimated from FL in 512 cases between 27-39 weeks of gestation showed that quadratic model has a good fit to the data and r2 = 0.785 with standard error + 8 days. There was a significant difference with Iranians and Bangladesh women in comparison to our findings. The paired t-test between Indian and Bangladesh, women was significant, (p < 0.001). The findings in our study were similar to the results of Western fetal FLs. Conclusion: The data can be useful in estimation of GA by FL. Our error was + 8 days. A bigger study involving same number of cases in each week of gestation in third trimester is necessary to get an accurate formula for assessment of GA by FL.
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OBJECTIVE: We investigated the usefulness of shortening of the fetal femur length (FL) and humeral length (HL) to predict Down syndrome at the middle gestation of pregnancy in Korean subjects. METHODS: This retrospective study involved 41 fetuses with Down syndrome and 328 fetuses with normal chromosome between 14+0 and 28+6 weeks of gestation. The expected FL and HL for any biparietal diameter (BPD) was calculated based on the control group data. The odds ratios for measure to expected FL and HL in comparison between normal fetuses and Down syndrome fetuses were calculated. The sensitivities of short FL and HL to predict Down syndrome were analyzed at a fixed false positive rate of 5%. RESULTS: The lengths of femur and humerus long bone for any BPD in Down syndrome group were significantly shorter than the lengths in control group (P<0.001). A low ratio of measured to expected FL and HL increased the risk of fetal Down syndrome (P<0.001). At a fixed false positive rate of 5%, the sensitivities were 21.3% (95% confidence interval [CI] 0.698~0.852, P<0.001) in FL and 29.9% (95% CI 0.773~0.914, P<0.001) in HL. CONCLUSION: Both of short FL and HL are poor marker for Down syndrome at the middle gestation of pregnancy in Korean population though the sensitivity of HL was higher than FL.
Subject(s)
Pregnancy , Down Syndrome , Femur , Fetus , Humerus , Odds Ratio , Prenatal Diagnosis , Retrospective StudiesABSTRACT
On 850 subjects, study was carried out on the correlation between the length of humerus and of femur (H/F) corresponding to the fetal age from 14 to 30 weeks. Results showed the reduction of H/F length ratio along the age because that the femur growth more quickly than the humerus. The ratio reduced from 0,99 in 19th week to 0,87 in 30th week. This correlation is very useful for antenatal diagnosis
Subject(s)
Humerus , Femur , Gestational Age , Prenatal DiagnosisABSTRACT
Study on the correlation between the femur length and gestational age from 14-30 weeks. Determination of numeric value table of femur length in correlation with centesimal line 5, 10, 50, 90 and 95 to make a basis to built fetus’s femur length chart, applying to monitor normal or malformation status of fetus. The results: fetus’femur length have a closely correlation with gestational age belong to a second-class function: y = 0.0019x2 +0.2377x + 11.1892, r = 0.97, in which, x = gestational age, y = femur length. Based on this chart, the accuracy of the dating random error about 1 week. The earlier, the estimation of gestational age, the more accurate
Subject(s)
Gestational Age , Femur , UltrasonographyABSTRACT
From September 1999 to September 2001, Institute of the Protection of Mother and New-borns, fetal femur length measured with a convexarray transducer,realtime ultrasound scanner in 115 normal monofetal gravid patients from 28 weeks of gestation. This study showed that fetal femur length was not different from last studies which have been done in the country. The growth rate of the femur length has also been calculated (1.67mm/wk). The relationship between femur length and gestational age is highly significant
Subject(s)
Pregnancy , Femur , UltrasonographyABSTRACT
Monitoring fetal growth and assessing its predictors have important place in antenatal care management. Accurate prediction of gestational age (GA) and birth weight (BW) is clinically important. Standard growth curve chosen should be evaluated to see if it satisfies the criteria for a valid assesment. In this paper, for the purpose of contributing to develop national standards and to evaluate Hadlock's standard data pertaining to 1411 fetuses were examined. Of 1411 normally growing fetuses, one measurement for AC, BPD and FL was taken by ultrasound. GA was assessed via menstrual history which is also confirmed by ultrasonography. Several variables, AC, BPD, FL, FL/AC, BPD/FL and dependent variables (GA & BW) were modelled mathematically. Percentile values, correlation coefficients were calculated and well functioning regression equations were produced for the fetal growth evaluation. Simple correlation model re-confirmed that AC, BPD and FL were well predictors of GA. Via modelling by multivariate regression analysis (adj. R2=937), GA=4.945 (95% CI: 4.661- 5.654) + .606 AC + .105 BPD + .286 FL can be estimated. It couldn't be possible establishing an appropriate equation for prediction of BW vith current data. Our study is intended to draw an attention on requirement of national standards although Hadlock's standard growth curve may evaluate fetal development accurately. Forming comprehensive cohort group is under our consideration. The equation we developped (shown in the results), might be a working contribution.
Subject(s)
Female , Humans , Pregnancy , Cross-Sectional Studies , Fetal Development , Gestational Age , Regression Analysis , Ultrasonography, PrenatalABSTRACT
The relationship between sonographically measured foetal length (FL) and abdominal circumference (AC) (expressed as FL/AC ratio * 100) was studied in 455 normal pregnancies between the 14th and 40th gestational weeks. By analysis of 1,197 measurements for each parameter, this ratio was found to be independent of menstrual age, with a normal range after 21 weeks (mean + 2 S.D.) of 2038 + 2.6. This mean ratio is different from the values of a previous western study (22+2). The ratio obtained from the Thai study hopefully will be the baseline for the Thai population and may be used for further study about intrauterine growth retardation.
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The preoperative measurement of adequate nail length is very important for femoral shaft fracture naiTing Operation. To reduce the disadvantages of scanography which are the fracture site pain, motion and radiation hazard, the simple external measurement method of intramedullary nail length was designated through this study. The fifty normal Korean whose bone growth v:as ceased were chosen for this study. And the lengths with the simple external measurement of thigh and scanogram of femur were compared at both side. The lateral roentgenographic view of femur was checked to analysis of anterior angulation at the proximal one third of femur was checked to analysis of anterior angulation at the proximal one third of femur. The following results were: 1. Femoral length was about 24% body height on an average. 2. The distance between the lower margin of the anterior superior iliac spine and the patellar upper pole (SPD) was equal to the distance between the tip of the greater trochanter and the cented of distal subchondral line. 3. Straight intramedullary nail length was 40 to 45 mm shorter than SPD. 4. The roentgenogram revealed that the femur took its anterior bowing by 9 degrees.