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Background: As biometric indices are difficult to obtain or show gross discrepancies with each other or with gestational age in the late trimester, so for accurate dating additional parameter is required. Fetal kidney length is easy to measure and appear reliable in previous studies.Methods: Well dated 121 antenatal women from 28 to 40 weeks of gestation with no obstetric or medical risk factors were recruited and kidney length is assessed in longitudinal scan and maximum length is taken. fetal kidney length derived gestational age compared with other biometrics indices gestational age.Results: Mean kidney length showed significant correlation (r=0.899, p<0.001 value) with increasing gestational age. Mean kidney length dated pregnancy within ±8.5 days.Conclusions: Fetal kidney length measurement correlated well with other routinely used parameters for the estimation of gestational age and can be used as an accurate parameter to date pregnancy in the late trimester.
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Background: Knowledge of the normal range of spleen size in the population being examined is very important because there are many different pathological conditions that may alter in spleen size. Also, gender, height, weight and BMI of individual, affect the splenic length and could result in incorrect interpretation of splenic measurements, spleen to left kidney ratio is one of recent parameter mention in literature aid in diagnosis of splenomegaly in children.Methods: The study was a cross-sectional study conducted in Khartoum state at Al-Buluk and Gaafar Ibnauf Paediatric Tertiary Hospital during the period from March 2018 to August 2018. A total of 101 children (males and females) with aged ranged 1 month to 5 years included in study. A transabdominal scan was performed, and measurement of spleen and left kidney taken after an ethical verbal consent from their parents, then data analyzed by SPSS, Mean±SD. Deviation for study variables calculated then correlation between patients factors and ultrasound measurements done.Results: The study found that the mean measurements of the normal size of the spleen and spleen to left kidney ratio for children up to five years of age, Splenic length was 7.24±1.12 cm, width was 3.83±0.81 cm , thickness 2.91±0.55 cm and spleen to left kidney ratio was 1.04±0.0.70 ranged (0.86-1.23). The male have larger spleen than female with no statistically significant differences in spleen sizes between the sexes. There was a strong significant correlation between age, weight, height spleen and left kidney length (p<0.01)respectively and a moderate association with BMI (p<0.05).Conclusions: Spleen and left kidneys was growing rapidly and similarly in infant up to one year of life 1 mm\1 mm for each month and then decreasing growth rate of kidney in relate to spleen for 1 mm growth of spleen kidney grow 0.8 mm in up to five years of age. There was strong significant positive correlation between spleen and left kidney measurement with age, height, weight of individual. The spleen to left kidney ratio for children up to five years ranged (0.86-1.23) with mean 1.04, so if the ratio less or more than this ranged it should be considered in clinical context for diagnosis of splenomegaly or shrunken spleen in children up to five years of age.
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Background: Accurate estimation of gestational age is important in providing appropriate antenatal care. Recent evidence suggests that weightage should also be given to kidney length in addition to standard biometric parameters in determining the duration of pregnancy by ultrasound.Methods: In a single centre, prospective cross-sectional study was done in 120 pregnant women. In addition to standard biometric parameters, kidney length was also measured between 24 to 40 weeks at two-week intervals. A total of 240 renal vertical measurements were done and average of right and left renal lengths was taken as a final kidney length. Descriptive analysis was carried out to find the mean and standard deviations for each variable. Regression analysis was carried for each variable either singly or in combinations and Pearson regression coefficients was used to find the association between gestational age and various foetal parameters and to determine which of the regression model gives the best fit for prediction of gestational age.Results: Foetal kidney length progressively increased throughout the gestation (from 23.2 mm at 24 weeks to 40.1 mm at 40 weeks). The regression formula using only kidney length as an independent variable (gestational age=2.195±0.942 X kidney length) had high degree of correlation (R2 0.97, p<0.001, SE of prediction 4.7±3.9), which was superior to other prediction models using standard biometric parameters. In multiple regression models using several conventional parameters, when femur length was added in a stepwise manner, there was significant improvement in forecasting gestational age.Conclusions: Present study showed that foetal kidney length is a reliable indicator of gestational age between 24 to 40 weeks of pregnancy and may be of utility in pregnancies with wrong dates, non-availability of dating scan and women who have conceived during lactational period.
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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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Background & objectives: Renal size is an important parameter used in the diagnosis and follow up of renal diseases. However, while making decisions, clinicians must be aware of the dependence of these dimensions on the ethnicity of the individual, independent of anthropometric indices. There is no established nomogram for renal sizes in the Indian population. The aim of this study was to assess the applicability of oft-quoted ranges of normal renal sizes in our population. Methods: Renal dimensions including length, width and parenchymal thickness were sonographically measured in 140 individuals with no renal disease. Analysis was done for differences due to age, gender and laterality. The correlation of renal dimensions with anthropometric parameters like weight, height, body mass index (BMI) and body surface area (BSA) was analyzed. Results: The means of length, width and parenchymal thickness of all 280 kidneys of 140 patients were 9.65 ± 0.63, 4.5 ± 0.42 and 2.04 ± 0.2 cm, respectively. There was a significant difference in parenchymal thickness between the right and left kidneys, while there was no significant right-left difference in length or width. Gender-wise analysis showed significant differences between male and female renal breadths but not length and parenchymal thickness. Age group-wise analysis showed significant decrease in renal length and parenchymal thickness beyond the seventh decade. There was a moderate positive correlation of bilateral renal length with body weight and BSA, and a weak positive correlation with body height and BMI. Interpretation & conclusions: Renal sizes in our population are in contrast to commonly quoted normal values in literature. Conclusions about renal sizes need to be made with reference to nomograms and should not be based upon data from other populations. We also present formulae whereby to derive renal sizes from anthropometric indices in our population.
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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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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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PURPOSE: Somatic growth is an important indicator of health in children. Adequate organ growth is essential in growth and directly related to body growth. We consider renal length as a surrogate of organ growth in growing children. Measurement of weight, height, and many anthropometric indices, such as body surface area (BSA), body mass index (BMI), and Rohrer and Kaup indices, are used to evaluate growth status. The aim of this study was to evaluate the association between renal length and somatic parameters and analyze the affecting factors for renal size during growth. METHODS: The data for renal length in 66 children (age, 12.9+/-15.6 months; male/female, 34/32) were obtained. Each kidney was measured with ultrasonography and dimercaptosuccinic acid scan. The data on age, sex, height, and weight were obtained from the medical records. BSA, BMI, and Rohrer and Kaup indices were calculated from measured height and weight. BSA was calculated by 2 methods, and is expressed as BSA I and BSA II. RESULTS: There were significant correlations between renal size and age, weight, height, BSA I, BSA II, and Rohrer index. In the regression analysis, the most significant contributing factor to renal growth was height (R2=0.636, P<0.001). CONCLUSION: Height seems to be the most important factor associated with organ growth in growing children. Further studies to evaluate adequate organ growth should be carried out.
Subject(s)
Child , Humans , Body Mass Index , Body Surface Area , Kidney , Medical Records , Pilot Projects , SuccimerABSTRACT
PURPOSE: Somatic growth is an important indicator of health in children. Adequate organ growth is essential in growth and directly related to body growth. We consider renal length as a surrogate of organ growth in growing children. Measurement of weight, height, and many anthropometric indices, such as body surface area (BSA), body mass index (BMI), and Rohrer and Kaup indices, are used to evaluate growth status. The aim of this study was to evaluate the association between renal length and somatic parameters and analyze the affecting factors for renal size during growth. METHODS: The data for renal length in 66 children (age, 12.9+/-15.6 months; male/female, 34/32) were obtained. Each kidney was measured with ultrasonography and dimercaptosuccinic acid scan. The data on age, sex, height, and weight were obtained from the medical records. BSA, BMI, and Rohrer and Kaup indices were calculated from measured height and weight. BSA was calculated by 2 methods, and is expressed as BSA I and BSA II. RESULTS: There were significant correlations between renal size and age, weight, height, BSA I, BSA II, and Rohrer index. In the regression analysis, the most significant contributing factor to renal growth was height (R2=0.636, P<0.001). CONCLUSION: Height seems to be the most important factor associated with organ growth in growing children. Further studies to evaluate adequate organ growth should be carried out.
Subject(s)
Child , Humans , Body Mass Index , Body Surface Area , Kidney , Medical Records , Pilot Projects , SuccimerABSTRACT
Background:The dimension and function of kidney have close relationship. In the developing countries, the index on kidney dimension of children has rather fully studied. In Viet Nam, most of studies only conducted on adults. Objectives:This study aims to determine the ultrasound kidney dimension and the correlation of kidney length and age, weight and height of children aged from 6 to 8 years old. Subjects and method: The data was obtained from a prospective study on 180 normal children at age from 6 to 8 years. Each kidney was measured length, width , thickness, and parenchymal thickness, and the mean values were recorded. The relationship of kidney length with age, body weight, body height were also taken. Results: Kidney dimension was increased by age. The average ultrasound kidney dimension:+ Right kidney: At 6 years old: Boy: length: 72.8\xb14; width: 31.2\xb13 ; thickness: 33.9\xb12 ; Girl: length: 69.8\xb15; width: 30.4\xb12 ; thickness: 32.7\xb12. At 7 years old: Boy: length: 75.2\xb14; width: 31.9\xb12; thickness: 33.8\xb13; Girl: length: 75.8\xb15; width: 32.0\xb12; thickness: 32.9\xb14; + Left kidney: At 6 years old: Boy: length: 73.9\xb15; width: 33.7\xb13 ; thickness: 34.9\xb12 ; Girl: length: 71.1\xb14; width: 32.4\xb13 ; thickness: 32.4\xb16. At 7 years old: Boy: length: 77.7\xb13; width: 33.8\xb13 ; thickness:34.7\xb12; Girl: length: 76.9\xb17; width: 32.0\xb12; thickness: 33,9\xb15; The kidney length, kidney weight, kidney volume of boys were bigger than girls, and the difference was significant (p<0.05). Conclusion: The kidney length correlated strongly and positively with body weight, body height and age.
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Child , KidneyABSTRACT
OBJECTIVE: There are reports that a history of low birth weight, and accordingly, a small kidney could be a risk factor for hypertension and end-stage renal disease in older age. We looked for factors that have an influence on the kidney size to make guidelines for follow up and early detection of renal diseases. METHODS: From April 2003 to October 2004, we studied the kidney size of neonates, who had an abdominal ultrasound done within two weeks of life. We measured the kidney length and anterior-posterior (AP) diameter and compared the values with each patient's gestational age, birth weight, height, body surface area (BSA), percentile, blood pressure, laboratory findings and various neonatal diseases. RESULTS: The kidney length and AP diameter had a good correlation with the patient's gestational age, birth weight, height and BSA. The kidney size was larger in the appropriate for gestational age (AGA) than in the small for gestational age (SGA) group in full term neonates. The kidney size did not have a correlation with systolic and diastolic blood pressure, laboratory findings, such as hemoglobin or hematocrit, and various diseases, except congenital heart disease, which had a weak correlation with kidney size. CONCLUSION: Neonates with early gestational period, low birth weight, small height and BSA tend to have a small kidney. Also SGA patients, especially symmetrical type, tend to have a small kidney. So we recommend high risk neonates to be followed up for early detection of hypertension and renal diseases.
Subject(s)
Humans , Infant, Newborn , Birth Weight , Blood Pressure , Body Height , Follow-Up Studies , Gestational Age , Heart Defects, Congenital , Hematocrit , Hypertension , Infant, Low Birth Weight , Kidney Failure, Chronic , Kidney , Risk Factors , UltrasonographyABSTRACT
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.