الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 107 |  |  |
| | | from | 107 | | |
Abstract
The management of all pregnancies, especially those deemed high-risk, depends on the accurate measurement of gestational age. In some cases, it may be necessary to terminate the pregnancy before the fetus reaches maturity. Preventing problems for the mother and the fetus depends on precisely determining the gestational age.
Among other biometric indicators, the purpose of this prospective comparative clinical study was to examine the accuracy of measuring fetal kidney length (FKL) and transcerebellar diameter (T.C.D.) in determining gestational age in healthy pregnancies. The research included seventy-seven pregnant women who were able to provide clear information about when they last menstruated or who had an ultrasound during the first trimester that confirmed their gestational age by measuring the crown-rump length. All of the ladies had one normal pregnancy and were in the 19–39 week mark. They were patients at Minia Maternity University Hospital’s prenatal and fetomaternal clinics from March 1, 2023, till the end of September 2023.
Qualified women were exposed to the following:
1. Clinical assessment:
A) A thorough history was obtained, including details such as name, age, residence, occupation, parity, presence of comorbidities like hypertension and diabetes mellitus, first day of last menstrual period (LMP), gestational age determined by date and initial ultrasound, history of drug use during pregnancy, drug allergies, and obstetric or operative complications. Previous obstetric history should include any instances of preterm labor, abortion, D & C procedures, cesarean sections, uterine surgeries, difficulties in past pregnancies, and issues during cesarean sections.
b) Clinical assessment: - Thorough general examination to rule out any systemic illnesses.
- Internal assessment:
1. Fundal level can be used to estimate gestational age based on historical information.
2. Fundal grasp.
3. Listening to the fetal heart rate.
2. Investigations: Routine and general diagnostic tests
1. Full blood count.
2. Blood glucose concentration.
3. Urinalysis.
Sonography may assess a variety of fetal indicators, including biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), kidney length (KL), and trans-cerebellar diameter (TCD).
- Fetal weight estimation
Amniotic fluid index.
The ultrasound machine calculated GA and effective fetal weight using regression equations derived from a combination of values obtained from the parameters assessed above, according to Hadlock tables.
The primary result of the study: 77 women participated, with an average age of 27.13 ± 5.31 years (range: 18 to 40 years). The median parity was 2 with a range of 0-6 times, whereas the median abortion rate was 3 with a range of 1-9 times.
• Most participants in the study lived in rural areas (77.9%) and the majority were housewives (79.2%).
• All individuals included in the study had regular menstrual cycles and were clinically healthy with no history of any medical conditions.
80.5% of the fetuses were in cephalic presentation, whereas 19.5% were in breech presentation.
The average gestational age was 30.22 ± 6.00 weeks, ranging from 18 to 39 weeks.
• The study found no significant difference in kidney size between the left and right kidneys.
• Strong positive relationships were found between gestational age, fetal measurements (BPD, HC, FL, and AC), mean fetal kidney length, and TCD.
• A notable positive association was found between the average length of the fetal kidney and other examined fetal parameters (BPD, HC, FL, and AC).
There was a notable positive association between TCD and other measured fetal indices such as BPD, HC, FL, and AC.
The strongest correlation coefficient was found between TCD and FL, and between FKL and AC.
There is a strong positive link between the average length of fetal kidneys in the newborns investigated and the trans-cerebellar diameter (mm) (r=0.854, p<0.001).
We suggest that both the FKL and TCD approaches may be utilized as reliable sonographic parameters for accurately determining fetal gestational age, particularly during the late 2nd and 3rd trimester, and when other measurement indices are not as precise.