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Gareeballah A, Alshoabi SA, Alharbi AM, Alali MH, Alraddadi WM, Al-Ahmadi FM, Dwaidy RM, Alamri R, Alkhoudair WA, Alsharif W, Elzaki M, Alsaedi AF, Gameraddin M, Abdulaal OM, Adam M. Accuracy of Transverse Cerebellar Diameter in Estimating Gestational Age in the Second and Third Trimester: A Prospective Study in Saudi Arabia. Diagnostics (Basel) 2025; 15:1130. [PMID: 40361948 PMCID: PMC12072083 DOI: 10.3390/diagnostics15091130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2025] [Revised: 04/18/2025] [Accepted: 04/25/2025] [Indexed: 05/15/2025] Open
Abstract
Background: Failure to accurately estimate gestational age remains an important dilemma for optimal evidence-based antenatal care. Currently, when the last menstrual period (LMP) is unknown, ultrasonography measurement is the best method for estimating gestational age (GA). This study aims to assess the feasibility and accuracy of ultrasonography measurement of the transverse cerebellar diameter (TCD) to deduce fetal GA after 13 weeks of gestation. Methods: A prospective study was conducted on 384 normal singleton pregnancies. Demographic information and biometric measurements, including TCD, were collected using a data sheet. The data were then analyzed using SPSS version 27, DATAtab, and the R program. Results: The study found a strong significant association between GA based on TCD and the LMP, GA based on femur length (FL), GA based on biparietal diameter (BPD), GA based on abdominal circumference (AC), and GA based on the average gestational age (AVG) (r = 0.976, 0.970, 0.966, 0.968, and 0.984, respectively, p < 0.001). Furthermore, there was perfect agreement between GA estimated using TCD and GA based on LMP, with a mean difference of 0.41 weeks and upper and lower limits of agreement of -1.43 to 2.26 weeks. Conclusions: Ultrasonography measurements of the TCD accurately predict gestational age with excellent concordance with GA based on the LMP, FL, AC, and BPD. TCD can be used as a reliable estimator of GA in the second and third trimesters of pregnancy with the benefit of its brain-sparing effect in fetuses of fetal intrauterine growth restriction pregnancies. Combining TCD with FL, BPD, and AC provides the most accurate method of GA prediction.
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Affiliation(s)
- Awadia Gareeballah
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia (A.M.A.); (W.A.); (M.E.); (M.G.); (O.M.A.)
| | - Sultan Abdulwadoud Alshoabi
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia (A.M.A.); (W.A.); (M.E.); (M.G.); (O.M.A.)
| | - Ashwaq Mohammed Alharbi
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia (A.M.A.); (W.A.); (M.E.); (M.G.); (O.M.A.)
| | - Mashael Hisham Alali
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia (A.M.A.); (W.A.); (M.E.); (M.G.); (O.M.A.)
| | - Wed Mubarak Alraddadi
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia (A.M.A.); (W.A.); (M.E.); (M.G.); (O.M.A.)
| | - Fadwa Mohammed Al-Ahmadi
- King Salman Medical City-Maternity and Children’s Hospital, Al-Madina Al-Munawwarah 42319, Saudi Arabia; (F.M.A.-A.); (R.A.)
| | - Reem Mustafa Dwaidy
- King Salman Medical City-Maternity and Children’s Hospital, Al-Madina Al-Munawwarah 42319, Saudi Arabia; (F.M.A.-A.); (R.A.)
| | - Rahaf Alamri
- King Salman Medical City-Maternity and Children’s Hospital, Al-Madina Al-Munawwarah 42319, Saudi Arabia; (F.M.A.-A.); (R.A.)
| | - Wessal Abdulkarim Alkhoudair
- King Salman Medical City-Maternity and Children’s Hospital, Al-Madina Al-Munawwarah 42319, Saudi Arabia; (F.M.A.-A.); (R.A.)
| | - Walaa Alsharif
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia (A.M.A.); (W.A.); (M.E.); (M.G.); (O.M.A.)
| | - Maisa Elzaki
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia (A.M.A.); (W.A.); (M.E.); (M.G.); (O.M.A.)
| | - Amirah Faisal Alsaedi
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia (A.M.A.); (W.A.); (M.E.); (M.G.); (O.M.A.)
| | - Moawia Gameraddin
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia (A.M.A.); (W.A.); (M.E.); (M.G.); (O.M.A.)
| | - Osama Mohammed Abdulaal
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia (A.M.A.); (W.A.); (M.E.); (M.G.); (O.M.A.)
| | - Mohammed Adam
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia;
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Bertucci E, Giulini S, Sighinolfi G, Benuzzi M, Lugli L. Prenatal ultrasound signs of Aarskog-Scott syndrome in a twin pregnancy: A case report. Int J Gynaecol Obstet 2024; 165:837-839. [PMID: 38217107 DOI: 10.1002/ijgo.15351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 01/15/2024]
Abstract
SynopsisWe describe the case of Aarskog‐Scott syndrome in a twin pregnancy with the prenatal finding of shortened fetal long bones.
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Affiliation(s)
- Emma Bertucci
- Obstetrics and Gynecology Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Simone Giulini
- Obstetrics and Gynecology Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Giovanna Sighinolfi
- Obstetrics and Gynecology Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Martina Benuzzi
- Obstetrics and Gynecology Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Licia Lugli
- Neonatal Intensive Care Unit, Women's and Children's Health Department, University Hospital of Modena, Modena, Italy
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Combs CA, Del Rosario A, Ashimi Balogun O, Bowman ZS, Amara S. Selection of Standards for Sonographic Fetal Femur Length by Use of z-scores. Am J Perinatol 2024; 41:e3147-e3156. [PMID: 37871638 DOI: 10.1055/a-2196-6835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
OBJECTIVES This study aimed to evaluate which of four established norms should be used for sonographic assessment of fetal femur length (FL). STUDY DESIGN Cross-sectional study using pooled data from four maternal-fetal medicine practices. Inclusion criteria were singleton fetus, gestational age (GA) 220/7 to 396/7 weeks, biometry measured, and fetal cardiac activity present. Four norms of FL were studied: Hadlock et al, the INTERGROWTH-21st Project (IG-21st), the World Health Organization Fetal Growth Curves (WHO), and the National Institutes of Child Health and Human Development Fetal Growth Studies, unified standard (NICHD-U). The fit of our FL measurements to each norm was assessed by these criteria: mean z-score close to 0, standard deviation (SD) of z close to 1, Kolmogorov-Smirnov D-statistic close to zero, Youden J-statistic close to 1, approximately 5% of exams <5th percentile, and approximately 5% of exams >95th percentile. RESULTS In 26,177 ultrasound exams, our FL measurements had the best fit to the WHO standard (mean z-score 0.15, SD of z 1.02, D-statistic <0.01, J-statistic 0.95, 3.4% of exams <5th percentile, 7.0% of exams >95th percentile). The mean of the IG-21st standard was smaller than the other norms and smaller than our measurements, resulting in underdiagnosis of short FL. The mean of the Hadlock reference was larger than the other norms and larger than our measurements, resulting in overdiagnosis of short FL. The SD of the NICHD-U standard was larger than the other norms and larger than our observations, resulting in underdiagnosis of both short and long FL. Restricting the analysis to a subgroup of 7,144 low-risk patients without risk factors for large- or small-for- GA produced similar results. CONCLUSION Of the norms studied, the WHO standard is likely best for diagnosis of abnormal FL. KEY POINTS · There are >30 norms for fetal FL.. · It is unknown which norm should be used.. · Our data fit the World Health Organization standard better than the other norms..
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Affiliation(s)
- C Andrew Combs
- Pediatrix Center for Research, Education, Quality & Safety, Pediatrix Medical Group, Sunrise, Florida
- Obstetrix of San Jose, Campbell, California
| | | | | | | | - Sushma Amara
- Eastside Maternal-Fetal Medicine Specialists, Bellevue, Washington
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Žaliūnas B, Jakaitė V, Kurmanavičius J, Bartkevičienė D, Norvilaitė K, Passerini K. Reference values of fetal ultrasound biometry: results of a prospective cohort study in Lithuania. Arch Gynecol Obstet 2022; 306:1503-1517. [DOI: 10.1007/s00404-022-06437-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/04/2022] [Indexed: 11/02/2022]
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