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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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Background: An accurate estimation of foetal gestation age is of utmost clinical significance owing to its vast clinical implications principally in management of high risk pregnancies. Aim: To determine correlation and regression coefficient of foetal kidney length as a parameter for gestational age and to do its comparative evaluation with other foetal biometric indices. Materials and methods: A Prospective observational study was conducted on 200 women aged between 18 to 35 years with normal singleton pregnancies, over a duration of six months from December 2015 to May 2016. Gestational age and fetal kidney length was determined using Ultrasound machine PHILIPS HD7 (2.0.1) with 3- 5 MHz curvilinear transducer. Statistical analysis was done using tests of correlation and simple linear regression. All analysis was done by using IBM SSPS statistics 24and MS excel. Results: Pearson’s correlation coefficient value of 0.99 and regression coefficient or slope 1.0 noted between gestational age and fetal kidney length with a significance P< 0.001. Bardhan J, Ghosh SK, Sarkar KN, Sarkar M. Fetal kidney length as a parameter for gestational age determination and its comparative evaluation with other fetal biometric indices. IAIM, 2016; 3(8): 36-44. Page 37 Conclusions: Fetal kidney length shows a positive correlation with fetal gestational age, with a linear growth rate throughout pregnancy irrespective of underlying medical condition like intrauterine growth retardation. This study shall prove its worth in cases of engaged fetal head, where it is difficult to measure fetal bi parietal diameter and head circumference as well as in cases of intrauterine growth retardation, macrosomia and malformation where abdominal circumference measurement gives false values.
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Introduction: Accuracy in estimation of gestational age (GA) has become more demanding as technology used in sonography has become more advanced. Patient’s expectations have also increased and they expect exact estimations to plan their pregnancies. Fetal kidney length (FKL) alone or in combination with other biometric indices can be used in estimating GA more precisely. Objective: The study aimed in measuring FKL and calculating GA using it as a single parameter and comparing the accuracy when combined with other biometric parameters used in estimation of GA on ultrasonography in third trimester in Indian women. Material and methods: Healthy pregnant women in third trimester with single live fetus with no maternal or fetal complications were selected for the study. FKL along with other biometric parameters were measured. The results were analyzed for finding if FKL could be used as a single parameter in estimation of GA and if the accuracy improved if combined with other indices. Results: GA was estimated in 715 cases by all four parameters in the women who came in the third trimester for ultrasonography. FKL was also measured simultaneously in these women. It was observed that average FKL increased linearly from 30.7 mm at 27 weeks to 39.4 mm at 38 weeks. Mean left kidney length was slightly but significantly more than the right kidney. GA was estimated by FKL alone and it gave results with SE ± 10.45 days and when combined with other indices accuracy improved to SE ± 5.45 days. Conclusion: FKL can be a single lone parameter in estimation of GA to give an accuracy of SE ± 10.45 days, but when used in combination with other four indices the accuracy increased to SE ± 5.5 days.
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Background: The normal histogenesis of human kidney during fetal life gives us information regarding histological maturation of kidney Objectives: - Present study aims at establishing details of histogenesis of human kidney with time of appearance of various microscopic elements. Methods: - The present study was conducted on kidneys of 59 human foetuses of gestational age ranging from16 to 38 weeks. The pieces of kidneys were processed and paraffin blocks were formed. Sections of kidney were cut which were studied with light microscope after staining. Results: - The subcapsular nephrogenic zone became narrow with increasing fetal age and disappeared at 38 weeks of gestation. In cortex, differentiation occurs from centre to periphery as indicated by more number of mature renal corpuscles and well differentiated proximal convoluted tubule, distal convoluted tubules in deeper part than superficial part of cortex. As the fetal age increases, the number of well differentiated tubules seen in medulla went on increasing. The histological structure of kidney was almost similar to kidney at 35 weeks of gestation. Conclusion:-This may help us in understanding various renal disorders. This study can also be used for determination of age of fetus.
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Fetal Kidney Length (FKL) is most accurate single parameter for estimating GA than other biometric indices in late 2nd and 3rd trimester and could be easily incorporated into the models for estimating GA. We evaluated role of FKL in estimation of gestational age (GA) in late 2nd & 3rd trimester. A total of 98 pregnant women with singleton pregnancy underwent serial biometric & FKL measurements ultrasonographically at 24, 28, 32, 36 and 38 weeks of gestation. These measurements were used to date the pregnancies relative to dating by last menstrual period. Linear regression models for estimation of GA were derived from the biometric indices and FKL. New models were constructed by combining different biometric indices and kidney length in various combinations. Comparison of accuracy in prediction of GA was made between individual parameters and these models to obtain best individual parameter and the best model in prediction of gestational age. Left FKL was slightly, but significantly longer than right FKL at each gestational period observed in the study. Standard error of prediction of GA was least for FKL (±8.56 days), closely followed by femur length (±8.9 days) and maximum for abdominal circumference (±11.72 days). The best model in estimating GA included all the five variables (femur length, FKL, biparietal diameter, head and abdominal circumference) with a standard error of ±7.41 days. FKL is the most accurate single parameter for estimating GA than other biometric indices in late 2nd and 3rd trimester and could be easily incorporated into the models for estimating GA.
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OBJECTIVE: To establish size ranges of normal fetal kidneys by ultrasonogram during pregnancy. METHODS: The A-P diameter and length of each of 450 kidneys in 225 consecutive fetuses between 19 and 41 weeks of gestation were measured on sonogram from March to August 2001 in Samsung Medical Center. Gestational ages were determined by last menstrual period and Crown-Rump Lengths of early stage of pregnancy. Abnormal fetuses, twins, offspring of diabetic mothers, and fetuses with renal pelvic dilatation of 5 mm or greater were excluded to avoid any questionable measurements. RESULTS: The results showed normal distribution and results were similar to previous reports. There was a strong correlation between fetal renal size and gestational age, but no significant difference between right and left renal sizes in fetuses. Average A-P diameter and renal lengths were significantly different when compared across the range of gestational ages (p<.001). CONCLUSION: As long as we know, this was the first report of size of the normal fetal kidney sonographically during pregnancy in Korea. We think that these results can be used to detect abnormality of fetal kidney and to estimate uncertain gestational age.
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Humans , Pregnancy , Crown-Rump Length , Dilatation , Fetus , Gestational Age , Kidney , Korea , Mothers , UltrasonographyABSTRACT
Metanephric adenoma is a rare renal epithelial tumor. Its light microscopic features are very characteristic, and immunohistochemical and electron microscopic studies are not critical to the diagnosis. The literature indicate that, to date, the tumor has behaved in a benign fashion, and predominantly but not exclusively occurred in middle-aged women. It occurs in a wide range up to 11 cm and is usually an incidental finding but may be symptomatic with hematuria or flank pain. Recently, we have experienced a case of renal tumor showing distinctive adenomatous features, which is incidentally found in a 52-year-old female. This tumor is confined to the renal cortex and is well-circumscribed with a characteristic uniform and orderly proliferation of compact well-differentiated small tubules lined by bland oval cells with a very low level of mitotic activity. The term metanephric adenoma is appropriate for this tumor because it accurately describes its bland proliferation of tubules and reflects the embryonic architectural and cytological appearance of this proliferation. The pattern of the tumor, with its occasional papillary glomeruloid- like bodies and foci of elongated tubules, is reminiscent of the fetal metanephric kidney.