ULTRASOUND MEASUREMENT OF FETAL KIDNEY LENGTH IN MORMAL PREGNANCY AND ITS CORRELATION WITH GESTATIONAL AGE
Abstract
An accurate gestational age (GA) is essential for the diagnosis of fetal growth and for planning the exact labour date which provides a better maternity care. Compared with the traditional methods of dating pregnancy using LMP and other clinical measurements, ultrasonographic dating has been recognized as the most accurate method of assessing GA. Any inaccuracy in estimation of GA lead to perinatal morbidity and mortality due to iatrogenic pre or post maturity.This study aimed to evaluate the accurate GA and precise scheduling of EDD by measuring FKL parameters using USG guided electronic calibration. This prospective study was carried out in 63 women with single uncomplicated pregnancy over a period of 1 year in Arogya Madha Hospital- Gengavalli, after getting an informed consent. Fetal Kidney Length (FKL) and BPD, FL, HC and AC were measured between 24th-28th week of gestation by using USG (Linear array Transducer). All the parameters were measured by using Electronic calipers, repeated twice and the mean values were calculated to reduce experimental variation. A t-test performed for comparing right and left kidney and it revealed that there is no difference in the length between rightt and left Kidneys. Paired Two Sample for Means P(T<=t) two-tail 0.21813301. In the present study, the FKL correlated with the GA with a correlation coefficient of 0.17157906 and a determination coefficient of 0.822 which was better than all the conventional parameters used. The study shows good correlation between gestational age derived from FKL and gestational age from established biometric indices like BPD, HC, AC, and FL.
Keywords: gestational age, ultrasound,kidney length
References
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21.Lawson T, Filey W, Berland L, Clark K. Ultrasonic evaluation of lens kidneys. Radiology 1981;(138) :153–156.
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23.Sagi J, Vagman I, David MP, et al. Fetal kidney size related to gestational age. Gynecol Obstet Invest 1987;23 (1):1–4.
24.Sampaio FJ, Mandarim-de-Lacerda CA, Prates JC. Allometric study of renal growth in human fetuses. Surg Radiol Anat 1989;11 (1):29–31 .
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28.Chitty LS, Altman DG. Charts of fetal size: kidney and renal pelvis measurements. Prenat Diagn 2003;23 (11):891–897.
29.Kansaria JJ, Parulekar SV. Nomogram for foetal kidney length. Bombay Hosp J 2009;51(2);155-162.
30.Nirmala Shivalingaiah Sowmya K, Ananya R, Kanmani TR, Marimuthu P. Fetal kidney length as a parameter for determination of gestational age in pregnancy. Int J Reprod Contracept Obstet Gynecol 2014;3 (2):424–427.
31.Edevbie JP, Akhigbe AO. Ultrasound measurement of fetal kidney length in normal pregnancy and correlation with gestational age. Niger J Clin Pract 2018;21 (8):960–966 .
32.Ahmadi F, Taqi Dizaj AV, Akhbari F, Hohreh Irani S, Holamreza Khalili G. Fetal kidney measurement in 26–39 weeks gestation in normal fetuses of Iranian pregnant women. J Pregnancy Child Health 2015; 2:139.
33.Filly PA, Feldstein VA. Ultrasound evaluation of normal fetal anatomy. In: Callen PW, ed. Ultrasonography in Obstetrics and Gynecology. 5th ed. Philadelphia: Saunders; 2007:342–343.
34.Witzani L, Brugger PC, Hörmann M, Kasprian G, Csapone-Balassy C, Prayer D. Normal renal development investigated with fetal MRI. Eur J Radiol 2006;57 (2):294–302. Basic Textbook of Ultrasound: Hylton B. Miere, 4th Ed. 617-675.
35.Chervenak FA et al, How accurate is fetal biometry in the assessment of fetal age? Am J. Obstet Gynecom 1998; 178: 678-87.
36.Scott JE, Wright B et al. (1995). Ultrasonographic measurement of Fetal Kidney. Br. J. Urol. 76: 768-774.
37.Thompson HE, Makowski EL. Estimation of birth weight and gestational age Obstet Gynecol 1971; 37: 44-47.
38.Ansari SM, Saha M, Paul AK, Mia SR, Sohel A et al. (1997) Ultrasonographic study of 793 Fetuses in Bangladesh. Aus. Radiol 41: 3-5.
39.Gloor JM et al. (1997) Fetal renal growth evaluated by prenatal ultrasound. Mayo Clin Prac 72: 124-129.
40.Rosati P (1996) Transvaginal Sonographic assessment of the fetal urinary tract in early pregnancy. Ultrasound Obstet Gynecol 7 : 95-100.
2.Robinson HP, Fleming JE. A critical evaluation of sonar “crown-rump length” measurements. Br J Obstet Gynaecol 1975;82 (9):702–710.
3.Campbell S. The prediction of fetal maturity by ultrasonic measurement of the biparietal diameter. J Obstet Gynaecol Br Commonw 1969;76 (7):603–609 .
4.Hadlock FP, Deter RL, Harrist RB, Park SK. Fetal biparietal diameter: a critical re-evaluation of the relation to menstrual age by means of real-time ultrasound. J Ultrasound Med 1982;1 (3):97–104.
5.Hadlock FP, Deter RL, Harrist RB, Park SK. Fetal head circumference: relation to menstrual age. AJR Am J Roentgenol 1982;138 (4):649–653.
6.O’Brien GD, Queenan JT, Campbell S. Assessment of gestational age in the second trimester by real-time ultrasound measurement of the femur length. Am J Obstet Gynecol 1981;139 (5):540–545.
7.Hadlock FP, Deter RL, Harrist RB, Park SK. Fetal abdominal circumference as a predictor of menstrual age. AJR Am J Roentgenol 1982;139 (2):367–370 .
8.Hadlock FP, Harrist RB, Deter RL, Park SK. Fetal femur length as a predictor of menstrual age: sonographically measured. AJR Am J Roentgenol 1982;138 (5):875–878.
9.Egley CC, Seeds JW, Cefalo RC. Femur length versus biparietal diameter for estimating gestational age in the third trimester. Am J Perinatol 1986;3 (2):77–79 .
10.Benson CB, Doubilet PM. Sonographic prediction of gestational age: accuracy of second- and third-trimester fetal measurements. AJR Am J Roentgenol 1991;157 (6):1275–1277.
11.Konje JC, Bell SC, Morton JJ, de Chazal R, Taylor DJ. Human fetal kidney morphometry during gestation and the relationship between weight, kidney morphometry and plasma active renin concentration at birth. Clin Sci (Lond) 1996;91 (2):169–175.
12.Butt K, Lim K; Diagnostic Imaging Committee. Determination of gestational age by ultrasound. J Obstet Gynaecol Can 2014;36 (2):171–181.
13.Garg A, Goyal N, Gorea RK, Pathak N, Mohan P. Normogram from fetal kidney length by ultrasonographically. J Punjab Acad Forensic Med Toxicol 2015;15:14–16 .
14.Gonzales J, Gonzales M, Mary JY. Size and weight study of human kidney growth velocity during the last three months of pregnancy. Eur Urol 1980;6(1):37–44 .
15.Bertagnoli L, Lalatta F, Gallicchio R, et al. Quantitative characterization of the growth of the fetal kidney. J Clin Ultrasound 1983;11 (7):349–356 .
16.Cohen HL, Cooper J, Eisenberg P, et al. Normal length of fetal kidneys: sonographic study in 397 obstetric patients. AJR Am J Roentgenol 1991;157( 3):545–548.
17.Konje JC, Okaro CI, Bell SC, de Chazal R, Taylor DJ. A cross-sectional study of changes in fetal renal size with gestation in appropriate- and small-for-gestational-age fetuses. Ultrasound Obstet Gynecol 1997;10 (1):22–26.
18.Gloor JM, Breckle RJ, Gehrking WC, et al. Fetal renal growth evaluated by prenatal ultrasound examination. Mayo Clin Proc 1997;72 (2):124–129 .
19.Konje JC, Abrams KR, Bell SC, Taylor DJ. Determination of gestational age after the 24th week of gestation from fetal kidney length measurements. Ultrasound Obstet Gynecol 2002;19 (6):592–597.
20.Yusuf N, Moslem FN, Haque JA, et al. Fetal kidney length: can be a new parameter for determination of GA in 3rd trimester. TAJ 2007;20 (2):147–150.
21.Lawson T, Filey W, Berland L, Clark K. Ultrasonic evaluation of lens kidneys. Radiology 1981;(138) :153–156.
22.Jeanty P, Dramaix-Wilmet M, Elkhazen N, Hubinont C, van Regemorter N. Measurements of fetal kidney growth on ultrasound. Radiology 1982;144 (1):159–162.
23.Sagi J, Vagman I, David MP, et al. Fetal kidney size related to gestational age. Gynecol Obstet Invest 1987;23 (1):1–4.
24.Sampaio FJ, Mandarim-de-Lacerda CA, Prates JC. Allometric study of renal growth in human fetuses. Surg Radiol Anat 1989;11 (1):29–31 .
25.Scott JE, Wright B, Wilson G, Pearson IA, Matthews JN, Rose PG. Measuring the fetal kidney with ultrasonography. Br J Urol 1995;76 (6):769–774.
26.Ansari SM, Saha M, Paul AK, Mia SR, Sohel A, Karim R. Ultrasonographic study of 793 foetuses: measurement of normal foetal kidney lengths in Bangladesh. Australas Radiol 1997;41 (1):3–5.
27.Fong KW, Ryan G. Fetal urogenital tract. In: Rumack CM, Wilson SR, Charboneau JW, eds. Diagnostic Ultrasound. 2nd ed. Vol. 2. New York: Mosby Year Book Inc.; 1998:1093–10121.
28.Chitty LS, Altman DG. Charts of fetal size: kidney and renal pelvis measurements. Prenat Diagn 2003;23 (11):891–897.
29.Kansaria JJ, Parulekar SV. Nomogram for foetal kidney length. Bombay Hosp J 2009;51(2);155-162.
30.Nirmala Shivalingaiah Sowmya K, Ananya R, Kanmani TR, Marimuthu P. Fetal kidney length as a parameter for determination of gestational age in pregnancy. Int J Reprod Contracept Obstet Gynecol 2014;3 (2):424–427.
31.Edevbie JP, Akhigbe AO. Ultrasound measurement of fetal kidney length in normal pregnancy and correlation with gestational age. Niger J Clin Pract 2018;21 (8):960–966 .
32.Ahmadi F, Taqi Dizaj AV, Akhbari F, Hohreh Irani S, Holamreza Khalili G. Fetal kidney measurement in 26–39 weeks gestation in normal fetuses of Iranian pregnant women. J Pregnancy Child Health 2015; 2:139.
33.Filly PA, Feldstein VA. Ultrasound evaluation of normal fetal anatomy. In: Callen PW, ed. Ultrasonography in Obstetrics and Gynecology. 5th ed. Philadelphia: Saunders; 2007:342–343.
34.Witzani L, Brugger PC, Hörmann M, Kasprian G, Csapone-Balassy C, Prayer D. Normal renal development investigated with fetal MRI. Eur J Radiol 2006;57 (2):294–302. Basic Textbook of Ultrasound: Hylton B. Miere, 4th Ed. 617-675.
35.Chervenak FA et al, How accurate is fetal biometry in the assessment of fetal age? Am J. Obstet Gynecom 1998; 178: 678-87.
36.Scott JE, Wright B et al. (1995). Ultrasonographic measurement of Fetal Kidney. Br. J. Urol. 76: 768-774.
37.Thompson HE, Makowski EL. Estimation of birth weight and gestational age Obstet Gynecol 1971; 37: 44-47.
38.Ansari SM, Saha M, Paul AK, Mia SR, Sohel A et al. (1997) Ultrasonographic study of 793 Fetuses in Bangladesh. Aus. Radiol 41: 3-5.
39.Gloor JM et al. (1997) Fetal renal growth evaluated by prenatal ultrasound. Mayo Clin Prac 72: 124-129.
40.Rosati P (1996) Transvaginal Sonographic assessment of the fetal urinary tract in early pregnancy. Ultrasound Obstet Gynecol 7 : 95-100.
Published
2020-07-03
How to Cite
CINNUSAMY, Maheswari; SHASTRI, Deepti; MARTINA, Josephine Arokia.
ULTRASOUND MEASUREMENT OF FETAL KIDNEY LENGTH IN MORMAL PREGNANCY AND ITS CORRELATION WITH GESTATIONAL AGE.
Journal of Morphological Sciences, [S.l.], v. 3, n. 1, p. 33-45, july 2020.
ISSN 2545-4706.
Available at: <http://www.jms.mk/jms/article/view/96>. Date accessed: 19 apr. 2024.
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