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Kwak DW, Yang JI, Song KH, Ryu HM, Han YJ, Kim MY, Chung JH. Prediction of Adverse Pregnancy Outcomes Using Crown-Rump Length at 11 to 13 + 6 Weeks of Gestation. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1195-1204. [PMID: 34486759 DOI: 10.1002/jum.15810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/24/2021] [Accepted: 08/01/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To assess the risk of a fetus with a smaller or larger than expected crown-rump length (CRL) for adverse pregnancy outcomes. METHODS The data of 960 healthy singleton pregnancies conceived via in vitro fertilization were retrospectively collected. Fetal CRL was measured between 11 and 13 + 6 weeks of gestation, and small and large fetal CRLs were defined as fetuses below the 10th and above the 90th centiles, respectively. Multiple logistic regression analysis was performed to assess the risk for adverse pregnancy outcomes. RESULTS The mean birth weights of fetuses with small, normal, and large CRLs were 3002 g, 3205 g, and 3378 g, respectively. A small fetal CRL was associated with an increased risk of smaller-than-gestational-age neonates (adjusted odds ratio [aOR], 2.79; 95% confidence interval [CI], 1.53-5.08; P < .001) and preterm delivery before 34 gestational weeks (aOR, 6.48; 95% CI, 1.36-30.79; P = .019). A large fetal CRL was associated with an increased risk of large-for-gestational-age (LGA) neonates, and the risk persisted even after adjustment for well-known risk factors of macrosomia, such as pre-pregnancy body mass index, gestational diabetes, and excessive gestational weight gain (aOR, 3.67; 95% CI, 2.04-6.59; P < .001). However, a large fetal CRL was associated with a decreased risk of gestational diabetes (aOR, 0.10; 95% CI, 0.01-0.76; P = .026). CONCLUSIONS Fetal CRL measured at 11 to 13 + 6 weeks gestation is worth using as a predictor of LGA as well as small for gestational age or preterm delivery.
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Affiliation(s)
- Dong Wook Kwak
- Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, South Korea
| | - Jeong In Yang
- Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, South Korea
| | - Kwan Heup Song
- Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, South Korea
| | - Hyun Mee Ryu
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - You Jung Han
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Moon Young Kim
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Jin Hoon Chung
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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Rotheneder S, González-Grajales LA, Beck H, Bootz F, Bollwein H. Variability of bovine conceptus-related volumes in early pregnancy measured with transrectal three-dimensional ultrasonography. J Dairy Sci 2022; 105:4534-4546. [PMID: 35307186 DOI: 10.3168/jds.2021-21006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 02/01/2022] [Indexed: 11/19/2022]
Abstract
Up until now, bovine fetometry has been entirely based on 2-dimensional ultrasonography. Fetal size is estimated by several linear measurements such as crown-rump length (CRL). However, the advent of 3-dimensional ultrasonography (3D-US) provides in vivo access to the volumes of the fetus and its amniotic sac. The objective of this preliminary observational study was to determine the variability of conceptus-related volumes using transrectal 3D-US in dairy cows and to identify factors affecting them. Furthermore, relationships between the gained measurements and calf birth weight were investigated. In total, 315 Simmental and Holstein-Friesian dairy cows were transrectally examined at d 42 after breeding using a portable ultrasound device (Voluson I, GE Healthcare). Gestational volumes including fetal volume (FV) and amniotic sac volume (ASV) were determined with the software tool VOCAL (Virtual Organ Computer-Aided Analysis, GE Healthcare), whereas amniotic fluid volume (AFV) values were derived from the subtraction of FV from ASV. The CRL was determined by means of 3-dimensional data. The mean values and standard deviations for FV, ASV, AFV, and CRL were 1.47 ± 0.25 cm3, 5.86 ± 1.22 cm3, 4.38 ± 1.02 cm3, and 2.38 ± 0.18 cm, respectively. All gestational volumes and CRL values were affected by breed. In Simmental cattle, larger concepti were observed compared with pregnancies derived from Holstein-Friesian animals. Parity affected only ASV and AFV, with heifers showing greater values than lactating cows. The CRL was positively associated with milk protein content. It was not possible to predict calf weight at birth by using FV, ASV, or AFV; however, tendencies were found for ASV and AFV. The present study was the first to adopt 3D-US volumetry to assess early pregnancy development in dairy cattle. Our results showed that this method could be used successfully to identify minor variations in conceptus growth.
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Affiliation(s)
- S Rotheneder
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland; Tierarztpraxis Herrmann, Rankhofstraße 24, 79274 St. Märgen, Germany.
| | - L A González-Grajales
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland
| | - H Beck
- Tierarztpraxis Dr. Bootz, Schlößlestraße 43, 88356 Ostrach, Germany
| | - F Bootz
- Tierarztpraxis Dr. Bootz, Schlößlestraße 43, 88356 Ostrach, Germany
| | - H Bollwein
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland
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Tsantekidou I, Evangelinakis N, Bargiota A, Vrachnis N, Kalantaridou S, Valsamakis G. Macrosomia and fetal growth restriction: evidence for similar extrauterine metabolic risks but with differences in pathophysiology. J Matern Fetal Neonatal Med 2021; 35:8450-8455. [PMID: 34555989 DOI: 10.1080/14767058.2021.1980531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To investigate and compare the causes of macrosomia and FGR fetuses, their ultrasound characteristics and the importance of their similar metabolic profile in intrauterine and extrauterine life. MATERIALS AND METHODS We searched Pubmed/Google Scholar database up until 15 December 2020 using keywords. Out of the 70 matching results we selected 50 most representative and matching papers. RESULTS We found similar causes and metabolic profiles and in both conditions offspring are at increased risk of developing metabolic and cardiovascular diseases in the extrauterine life. CONCLUSION Despite similarities of the maternal factors and fetal metabolic profile it is still unknown which of them has worse metabolic status during intrauterine and extrauterine life.
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Affiliation(s)
- Inga Tsantekidou
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Evangelinakis
- Reproductive Endocrinology Unit, 3rd Department of Obstetrics and Gynecology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens Greece, Athens, Greece
| | - Alexandra Bargiota
- Department of Endocrinology and Metabolic Disorders, University Hospital of Larissa, Medical School of Larissa, University of Thessaly, Larissa, Greece
| | - Nikolaos Vrachnis
- Reproductive Endocrinology Unit, 3rd Department of Obstetrics and Gynecology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens Greece, Athens, Greece
| | - Sophia Kalantaridou
- Reproductive Endocrinology Unit, 3rd Department of Obstetrics and Gynecology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens Greece, Athens, Greece
| | - Georgios Valsamakis
- Department of Endocrinology and Metabolic Disorders, University Hospital of Larissa, Medical School of Larissa, University of Thessaly, Larissa, Greece.,2nd Department of Obstetrics and Gynecology, University Hospital "Aretaieion", Medical School, National and Kapodistrian University of Athens Greece, Athens, Greece
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Gootjes DV, Koster MPH, Willemsen SP, Koning AHJ, Steegers EAP, Steegers-Theunissen RPM. The Impact of Neighbourhood Deprivation on Embryonic Growth Trajectories: Rotterdam Periconception Cohort. J Clin Med 2019; 8:jcm8111913. [PMID: 31717297 PMCID: PMC6912493 DOI: 10.3390/jcm8111913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 11/04/2019] [Indexed: 11/21/2022] Open
Abstract
Background: Neighbourhood deprivation is a risk factor for impaired health and adverse pregnancy outcomes. We investigated whether living in a deprived neighbourhood is associated with embryonic growth. Methods: From the Predict cohort, we studied 566 women who underwent repeated first trimester ultrasound examinations. Crown rump length (CRL; n = 1707) and embryonic volume (EV; n = 1462) were measured using three-dimensional techniques. Neighbourhood deprivation was assessed using the neighbourhood status scores (NSS) of the Dutch Social Cultural Planning office. A high NSS represents a non-deprived neighbourhood. Associations between the NSS and embryonic growth were investigated using linear mixed models. Adjustment was performed for individual-level factors: maternal age, geographic origin, educational level, BMI, folic acid supplement use, fruit and vegetable intake, alcohol use and smoking habits. Results: The NSS was negatively associated with embryonic growth: a higher score (a less deprived neighbourhood) was associated with a smaller CRL and EV; adjusted β: −0.025 (95% CI −0.046, −0.003) and adjusted β: −0.015 (95% CI −0.026, −0.003). At 11 weeks of pregnancy, we observed a 0.55 cm3 smaller EV (7.65 cm3 vs. 7.10 cm3) and 1.08 mm smaller CRL (43.14 mm vs. 42.06 mm) in the highest compared to the lowest category. Conclusion: In deprived neighbourhoods, embryos are larger than in non-deprived neighbourhoods.
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Affiliation(s)
- Dionne V. Gootjes
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands (M.P.H.K.); (S.P.W.); (E.A.P.S.)
| | - Maria P. H. Koster
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands (M.P.H.K.); (S.P.W.); (E.A.P.S.)
| | - Sten P. Willemsen
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands (M.P.H.K.); (S.P.W.); (E.A.P.S.)
- Department of Biostatistics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands
| | - Anton H. J. Koning
- Department of Pathology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands;
| | - Eric A. P. Steegers
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands (M.P.H.K.); (S.P.W.); (E.A.P.S.)
| | - Régine P. M. Steegers-Theunissen
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands (M.P.H.K.); (S.P.W.); (E.A.P.S.)
- Correspondence: ; Tel.: +31-010-703-8255
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Simic M, Wikström AK, Stephansson O. Accelerated fetal growth in early pregnancy and risk of severe large-for-gestational-age and macrosomic infant: a cohort study in a low-risk population. Acta Obstet Gynecol Scand 2017; 96:1261-1268. [PMID: 28683173 DOI: 10.1111/aogs.13189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 06/29/2017] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Our objective was to examine the association between fetal growth in early pregnancy and risk of severe large-for-gestational-age (LGA) and macrosomia at birth in a low-risk population. MATERIAL AND METHODS Cohort study that included 68 771 women with non-anomalous singleton pregnancies, without history of diabetes or hypertension, based on an electronic database on pregnancies and deliveries in Stockholm-Gotland Region, Sweden, 2008-2014. We performed multivariable logistic regression to estimate the association between accelerated fetal growth occurring in the first through early second trimester as measured by ultrasound and LGA and macrosomia at birth. Restricted analyses were performed in the groups without gestational diabetes and with normal body mass index (18.5-24.9 kg/m2 ). RESULTS When adjusting for confounders, the odds of having a severely LGA or macrosomic infant were elevated in mothers with fetuses that were at least 7 days larger than expected as compared with mothers without age discrepancy at the second-trimester scan (adjusted odds ratio 1.80; 95% CI 1.23-2.64 and adjusted odds ratio 2.15; 95% CI 1.55-2.98, respectively). Additionally, mothers without gestational diabetes and mothers with normal weight had an elevated risk of having a severely LGA or macrosomic infant when the age discrepancy by second-trimester ultrasound was at least 7 days. CONCLUSIONS In a low-risk population, ultrasound-estimated accelerated fetal growth in early pregnancy was associated with an increased risk of having a severely LGA or macrosomic infant.
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Affiliation(s)
- Marija Simic
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital and Institutet, Stockholm, Sweden
| | - Anna-Karin Wikström
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital and Institutet, Stockholm, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Olof Stephansson
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital and Institutet, Stockholm, Sweden.,School of Public Health, University of California, Berkeley, CA, USA
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Hackmon R, Librach C, Burwick R, Rodrigues N, Farine D, Berger H. Do Early Fetal Measurements and Nuchal Translucency Correlate With Term Birth Weight? JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2017; 39:750-756. [PMID: 28733063 DOI: 10.1016/j.jogc.2017.04.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/04/2017] [Accepted: 04/16/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Traditionally, physiological variation in fetal weight is believed to emerge during the latter half of pregnancy. Although recent evidence suggests that crown-rump length (CRL) and nuchal translucency (NT) measured at 11-14 weeks correlate with abnormal fetal growth, findings have been limited by dating accuracy in spontaneous gestations. Therefore, we sought to determine whether CRL or NT measurements correlated with term birth weight (BW) or BW ratio in a cohort of IVF pregnancies, in which the date of conception is precisely known. METHODS This retrospective cohort study included 227 term, singleton IVF pregnancies. Subjects were included if they had an early first-trimester ultrasound examination and subsequent nuchal translucency (NT) screening. The difference between the measured and the expected CRL and the biparietal diameter (BPD) and NT measurement were calculated and correlated with the actual term BW or BW ratio. The BW ratio was calculated using the actual BW and the expected BW for GA. RESULTS The difference between measured and expected mid-first-trimester CRL, and the BPD at NT assessment, correlated with BW ratio at delivery (rSpearman = 0.15, P = 0.023 and rSpearman = 0.27, P < 0.001, respectively). Absolute NT measurements and NT percentiles (adjusted for CRL) correlated with BW ratio at delivery (rSpearman = 0.18, r = 0.14, and P = 0.005 and 0.038, respectively). CONCLUSION In this well-dated IVF population, we report a significant correlation between BW ratio and first-trimester CRL, BPD, and NT measurements. These findings support the hypothesis that physiological variation in BW can be reflected by variation in first-trimester fetal measurements.
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Affiliation(s)
- Rinat Hackmon
- Maternal Fetal Medicine Unit, Saint Michael's Hospital, Toronto, ON; Maternal Fetal Medicine Unit, Mount Sinai Hospital, Toronto, ON; Maternal Fetal Medicine Division, Obstetrics and Gynecology, School of Medicine, Oregon Health and Science University, Portland, OR.
| | - Clifford Librach
- Family Medicine Obstetrics, Sunnybrook Health Sciences Centre, Toronto, ON; Gynecology Program, Women's College Hospital, Toronto, ON; Create Fertility Centre, Toronto, ON
| | - Richard Burwick
- Maternal Fetal Medicine Division, Obstetrics and Gynecology, School of Medicine, Oregon Health and Science University, Portland, OR
| | | | - Dan Farine
- Maternal Fetal Medicine Unit, Mount Sinai Hospital, Toronto, ON
| | - Howard Berger
- Maternal Fetal Medicine Unit, Saint Michael's Hospital, Toronto, ON
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Ustunyurt E, Simsek H, Korkmaz B, Iskender C. First-trimester crown-rump length affects birth size symmetrically. J Matern Fetal Neonatal Med 2014; 28:2070-3. [DOI: 10.3109/14767058.2014.978278] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Emin Ustunyurt
- Department of Obstetrics and Gynecology, Bursa Şevket Yılmaz Research and Education Hospital, Bursa, Turkey and
| | - Harun Simsek
- Department of Obstetrics and Gynecology, Bursa Şevket Yılmaz Research and Education Hospital, Bursa, Turkey and
| | - Barış Korkmaz
- Department of Obstetrics and Gynecology, Bursa Şevket Yılmaz Research and Education Hospital, Bursa, Turkey and
| | - Cantekin Iskender
- Department of Perinatology, Dr Zekai Tahir Burak Research and Training Hospital, Ankara, Turkey
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Álvarez Silvares E, Vázquez Rodríguez M, Castro Vilar L, Alves Pérez M. Niveles de proteína placentaria A asociada a la gestación: Predictor de macrosomía fetal en gestantes no diabéticas. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2014. [DOI: 10.1016/j.gine.2013.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Timmerman E, Pajkrt E, Snijders RJM, Bilardo CM. High macrosomia rate in healthy fetuses after enlarged nuchal translucency. Prenat Diagn 2014; 34:103-8. [DOI: 10.1002/pd.4262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 10/15/2013] [Accepted: 10/17/2013] [Indexed: 11/08/2022]
Affiliation(s)
- E. Timmerman
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology; Academic Medical Centre Amsterdam; The Netherlands
| | - E. Pajkrt
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology; Academic Medical Centre Amsterdam; The Netherlands
| | - R. J. M. Snijders
- Prenatal Screening Foundation Northeast of the Netherlands; Groningen The Netherlands
| | - C. M. Bilardo
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology; University Medical Centre; Groningen The Netherlands
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Mayer C, Joseph KS. Fetal growth: a review of terms, concepts and issues relevant to obstetrics. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2013; 41:136-45. [PMID: 22648955 DOI: 10.1002/uog.11204] [Citation(s) in RCA: 154] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/07/2012] [Indexed: 05/26/2023]
Abstract
The perinatal literature includes several potentially confusing and controversial terms and concepts related to fetal size and growth. This article discusses fetal growth from an obstetric perspective and addresses various issues including the physiologic mechanisms that determine fetal growth trajectories, known risk factors for abnormal fetal growth, diagnostic and prognostic issues related to restricted and excessive growth and temporal trends in fetal growth. Also addressed are distinctions between fetal growth 'standards' and fetal growth 'references', and between fetal growth charts based on estimated fetal weight vs those based on birth weight. Other concepts discussed include the incidence of fetal growth restriction in pregnancy (does the frequency of fetal growth restriction increase or decrease with increasing gestation?), the obstetric implications of studies showing associations between fetal growth and adult chronic illnesses (such as coronary heart disease) and the need for customizing fetal growth standards.
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Affiliation(s)
- C Mayer
- Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital of British Columbia, Vancouver, Canada
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Marsoosi V, Pirjani R, Jamal A, Eslamian L, Rahimi-Foroushani A. Second trimester biparietal diameter size and the risk of adverse pregnancy outcomes. Prenat Diagn 2011; 31:995-8. [DOI: 10.1002/pd.2823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 06/09/2011] [Accepted: 06/09/2011] [Indexed: 11/05/2022]
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Salomon LJ, Hourrier S, Fanchin R, Ville Y, Rozenberg P. Is first-trimester crown-rump length associated with birthweight? BJOG 2011; 118:1223-8. [DOI: 10.1111/j.1471-0528.2011.03009.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Weissmann-Brenner A, Weisz B, Lerner-Geva L, Gindes L, Achiron R. Increased nuchal translucency is associated with large for gestational age neonates in singleton pregnancies. J Perinat Med 2011; 39:305-9. [PMID: 21391873 DOI: 10.1515/jpm.2011.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the correlation between sonographic measurements of nuchal translucency (NT) and neonatal birth weight in non-diabetic population. METHODS A retrospective analysis was performed on all singleton term pregnancies delivered at our hospital between 2004 and 2008. Data collected included maternal age, parity, NT measurement, results of glucose challenge test, birth weight, gestational age at delivery, and fetal gender. RESULTS The study population comprised of 1649 patients. The mean NT was 1.3 ± 0.5 mm. Male fetuses had a significantly thicker NT (1.3 ± 0.5 vs. 1.2 ± 0.4; P<0.001). NT significantly correlated to birth weight (P=0.002). This correlation was independent of neonatal gender. The median NT in the large for gestational age (LGA) neonates was significantly higher than in the non-LGA neonates (1.4 mm vs. 1.2 mm, P=0.001). Equations for the predicted probability for delivering LGA neonates were derived using either NT alone or in combination with parity. An increase in 0.1 mm in the NT has the odd ratio of 1.042 for delivering an LGA neonate (P=0.02). CONCLUSIONS NT correlated with LGA neonates in term non-diabetic patients. This correlation was independent of the neonatal gender. The predictive clinical impact of NT was limited to LGA neonates.
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Affiliation(s)
- Alina Weissmann-Brenner
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Tel HaShomer, Israel.
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El Daouk M, Langer O, Lysikiewicz A. First-trimester crown-rump length as a predictor of fetal LGA and SGA at term. J Matern Fetal Neonatal Med 2011; 25:162-4. [DOI: 10.3109/14767058.2011.566653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Beneventi F, Simonetta M, Lovati E, Albonico G, Tinelli C, Locatelli E, Spinillo A. First trimester pregnancy-associated plasma protein-A in pregnancies complicated by subsequent gestational diabetes. Prenat Diagn 2011; 31:523-8. [DOI: 10.1002/pd.2733] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Revised: 02/03/2011] [Accepted: 02/07/2011] [Indexed: 11/11/2022]
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Abstract
Sonography is a fundamental tool in the management of pregnancies affected by maternal diabetes. Purposeful use of ultrasound in each trimester provides an invaluable amount of information about the developing fetus including gestational age and growth patterns, anatomical structure and function, assessment of fetal well-being, and prediction of adverse outcome. There are great ongoing research efforts in this field of prenatal diagnosis and management, yet even more are needed.
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Affiliation(s)
- Jennifer M McNamara
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Washington University School of Medicine, 4911 Barnes-Jewish Plaza, 5th Floor Maternity Building, Campus Box 8064, Saint Louis, MO 63110, USA.
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Antsaklis A, Anastasakis E, Komita O, Theodora M, Hiridis P, Daskalakis G. First trimester 3D volumetry. Association of the gestational volumes with the birth weight. J Matern Fetal Neonatal Med 2011; 24:1055-9. [PMID: 21247238 DOI: 10.3109/14767058.2010.545915] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the three dimensional ultrasound (3D) in the volume assessment of the gestational contents during the 1st trimester of pregnancy. Our aim was to correlate the embryo, gestational sac, and placenta volume with the birth weight. To monitor the increase of these volumes according to the gestational age. METHOD Prospective study of 199 singleton low risk pregnant women undergoing the 1st trimester ultrasound for fetal anomalies. In these women, gestational volumetry was performed and it was compared with the crown-rump length (CRL). Regression models were computed in order to analyze the dependence of birth weight with the volumes. RESULTS The embryo volume reveals the strongest association with the birth weight at delivery (β = 0.24), followed by the CRL (β = 0.20) and the gestational sac volume (β = 0.20). The placenta volume appears the weakest association with fetal weight at delivery (β = 0.16). All volumes increased significantly from 11(+0)-11(+6) to 13(+0)-13(+6) weeks of gestation (p < 0.001). Ten cubic millimeter increase in embryo volume corresponds to a mean birth weight increase of 75 g, while 1 mm increase in the CRL corresponds to a birth weight increase of 113 g. CONCLUSION Our results provide evidence that the embryo volume during the first trimester of pregnancy correlates better with birth weight than the CRL. This might assist in the identification of the high risk pregnancies caring macrosomic and low birth weight fetuses.
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Affiliation(s)
- Aris Antsaklis
- Fetal-Medicine Unit, 1st Department of Obstetrics and Gynaecology, "Alexandra" Maternity Hospital, University of Athens, Athens, Greece
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Pardo J, Peled Y, Yogev Y, Melamed N, Ben-Haroush A. Association of crown-rump length at 11 to 14 weeks' gestation and risk of a large-for-gestational-age neonate. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:1315-1319. [PMID: 20733187 DOI: 10.7863/jum.2010.29.9.1315] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the association between crown-rump length (CRL) and the risk of a large-for-gestational-age (LGA) neonate. METHODS Data were retrospectively collected on consecutive women with a healthy singleton pregnancy followed to delivery at our center from 2003 to 2006 who underwent nuchal translucency, pregnancy-associated plasma protein-A, and free beta-human chorionic gonadotropin screening at 11 to 14 weeks' gestation. Pregnancies were dated by the last menstrual period (LMP) confirmed by CRL at 6 to 10 weeks or the known time of fertilization. The fetal CRL at 11 to 14 weeks was obtained from frozen sonographic images. The measured CRL was converted to gestational weeks using the method of Hadlock et al (Radiology 1992; 182:501-505). The expected gestational age (GA) by the LMP was subtracted from the measured GA to yield the DeltaCRL. The association between the DeltaCRL and birth weight was statistically analyzed. RESULTS The sample included 521 women. Fifty neonates (9.6%) were LGA (>or=90th percentile), 38 (7.3%) small for gestational age, and 433 (83.1%) appropriate for gestational age. The LGA group was characterized by significantly larger-than-expected CRL measurements (P = .033). The birth weight percentile and rate of LGA neonates were significantly higher in pregnancies in which the DeltaCRL was 1/2 week or greater (P = .007 and .033, respectively). There was a significant linear correlation between the DeltaCRL and birth weight percentile (P = .001). On multivariate logistic regression analysis, the DeltaCRL was the only significant predictor of an LGA neonate (odds ratio, 1.6; 95% confidence interval, 1.07-2.4; P = .023). CONCLUSIONS Pregnancies with LGA neonates are characterized by larger-than-expected CRL measurements at 11 to 14 weeks' gestation.
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Affiliation(s)
- Joseph Pardo
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tiqwa, Israel
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Thorsell M, Kaijser M, Almström H, Andolf E. Large fetal size in early pregnancy associated with macrosomia. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2010; 35:390-394. [PMID: 20069673 DOI: 10.1002/uog.7529] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To assess if fetal size at the time of ultrasound dating examination is associated with the risk of macrosomia and complications associated with macrosomia. METHODS This was a retrospective cohort study of 19 377 singleton pregnancies dated in gestational weeks 16-20 during the period 1998-2004 at Danderyd Hospital, Stockholm, Sweden. Obstetric outcome was assessed through linkage to the Swedish Medical Birth Register. RESULTS When fetuses were > or = 7 days larger than expected at dating, compared with the expected size according to last menstrual period, there was a 59% increase in the risk of birth weight > or = 4500 g and a 145% increase in the risk of birth weight > or = 5000 g (odds ratio (OR), 1.59; 95% CI, 1.12-2.24 and OR, 2.45; 95% CI, 1.22-4.90, respectively). For a birth weight of > or = 4000 g the risk estimate was 1.19 (95% CI, 0.96-1.47). CONCLUSION Fetuses that are larger than expected in the second trimester have an increased risk of macrosomia. This emphasizes that fetal size in early pregnancy is not only a function of gestational duration, but also of fetal growth. However, only a limited proportion of all infants born macrosomic can be identified as such at the time of ultrasound dating.
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Affiliation(s)
- M Thorsell
- Division of Obstetrics and Gynaecology, Danderyd Hospital, Stockholm, Sweden.
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Salomon LJ. Early fetal growth: concepts and pitfalls. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2010; 35:385-389. [PMID: 20373482 DOI: 10.1002/uog.7623] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- L J Salomon
- Université Paris Descartes, Service de Gynécologie Obstétrique, Centre Hospitalo-Universitaire Necker-Enfants Malades, AP-HP, 75015 Paris, France.
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Hod M, Pardo J. Environmental rather than genetic fetal overgrowth: defining the difference and hints for diagnosis and management. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2009; 33:375-378. [PMID: 19306468 DOI: 10.1002/uog.6352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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