DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20175835

Efficacy of transverse cerebellar diameter/abdominal circumference ratio: a gestational age independent parameter in assessing fetal growth restriction

Saritha Chinnappan, Malarvizhi Loganathan

Abstract


Background: It is important to identify fetal growth restriction (FGR) antenatally because it is associated with increased perinatal morbidity and mortality. There is difficulty in diagnosis of fetal growth restriction using standard ultrasonographic parameters as they are gestational age related and are not reliable in cases of symmetrical growth restriction. Therefore, there is a need for gestational age independent biometric parameter, which can diagnose fetal growth restriction in unknown gestational age and can diagnose both symmetric and asymmetric fetal growth restriction. In this study transverse cerebellar diameter (TCD)/abdominal circumference (AC) ratio used to diagnose fetal growth restriction. Objectives of the study were to evaluate the validity of TCD/AC ratio in diagnosing fetal growth restriction and to find out the cut-off value of TCD/AC ratio for diagnosis of fetal growth restriction.

Methods: This study was carried out for 12 months and sample size was 100. Transverse cerebellar diameter, abdominal circumference measured between 20-22wks and 32-34weeks of gestation and transverse cerebellar diameter and abdominal circumference ratio calculated.

Results: TCD/AC ratio was fairly constant throughout the pregnancy. Fetuses with TCD/AC ratio more than 2SD of the mean were found growth restricted on examination. The TCD/AC ratio more accurate in diagnosing fetal growth restriction (FGR).

Conclusions: As the TCD/AC ratio is constant, it is a gestational age - independent parameter, can diagnose FGR in antenatal women with unknown gestational age. Hence, TCD/AC ratio can be a screening test to diagnose FGR in the antenatal period.


Keywords


AC, FGR, Gestational age, Perinatal morbidity, TCD, TCD/AC ratio

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References


Williams. Fetal growth disorders. Obstetrics. 23rd ed. McGraw-Hill Companies;2010:843.

Berhman RE, Hers MH, de Peterson EN, Lannoy CW, Seeds AE. Distribution of the circulation in the normal and asphyxiated primate. Am J Obstet Gynecol. 1970;108:956-96.

Hadlock FP, Deter RL, Harrist RB. Sonographic detection of abnormal growth patterns. Clin Obstet Gynecol. 1984;27:342-51.

Meyer WJ, Gauthier DW, Goldenberg B, Santolaya J, Sipos J, Catledge F. The fetal transverse cerebellar diameter/abdominal circumference ratio: a gestational age- independent method of assessing fetal size. J Ultrasoud Med. 1993 Jul;12(7):379-82.

Haller H, Petrović O, Rukavina B. Fetal transverse cerebellar diameter/abdominal circumference ratio in assessing fetal size. Int J Gynecol Obstet. 1995 Aug 1;50(2):159-63.

Dilmen G, Toppare MF, Turhan NÖ, Öztürk M, Işik S. Transverse cerebellar diameter and transverse cerebellar diameter/abdominal circumference index for assessing fetal growth. Fetal Diagn Ther 1996;11:50-6.

Campbell WA, Nardi D, Vintzileos AM, Rodis JF, Turner GW, Egan JF. Transverse cerebellar diameter/abdominal circumference ratio throughout pregnancy: a gestational age-independent method to assess fetal growth. Obstet Gynecol. 1991 Jun;77(6):893-6.

Goldstien I, Reece EA, Gianluigi P, Bovicelli L, Hobbins JC. Cerebellar measurements with ultrasonography in the evaluation of fetal growth and development. Am J Obstet Gynecol. 1987;156:1065-9.

Vinkesteijn AS, Mulder PG, Wlamidiroff JW. Fetal transverse cerebellar diameter measurements in normal and reduced fetal growth. Ultrasound Obstet Gynecol. 2000;15:47-51.

Meyer WJ, Gauthier D, Ramakrishnan V, Sipos J. Ultrasonographic detection of abnormal fetal growth with the gestational age-independent, transverse cerebellar diameter /abdominal circumference ratio. Am J Obstet Gynecol. 1994;171:1057.