n Obstetrics and Gynaecology Forum - A retrospective study to assess the accuracy of the fetal transcerebellar diameter, measured in late pregnancy, to estimate the gestational age in a local cohort of women in KwaZulu-Natal, South Africa - original research

Volume 29 Number 4
  • ISSN : 1029-1962


Introduction: Dating pregnancy conventionally (using last menstrual period and standard biometry) is inaccurate in late pregnancy though transcerebellar diameter (TCD) has accurately estimated GA (eGA) in many settings in late pregnancy.

Aim: To determine if GA can be accurately estimated from the TCD measured in late pregnancy in a local population.

Methods: Chart reviews of all women attending the Fetal Unit at Inkosi Albert Luthuli Central Hospital over 2 years was conducted. Data was analysed using SPSS (version 25). Correlation between the eGA by early ultrasound (EUS) and the late eGA by TCD and standard biometry were assessed using the Pearson correlation coefficient. EGAs using standard biometry and TCD were analysed for agreement with eGA by EUS using Bland Altman plots.

Results: In comparison to standard biometry: eGA by TCD correlated most closely with that by EUS (r = 0.956; p<0.01); at < 32 weeks and ≥ 32 weeks eGA by TCD showed the highest correlation (r = 0.932 and r= 0.808 respectively; p<0.01) with that of EUS; eGA by TCD showed the least variation in r-value in different growth patterns eg. large for GA and intrauterine growth restriction and eGA by TCD showed no signifi cant differences in correlation to eGA by EUS in different BMI categories (range r = 0.945 to r= 0.961; p<0.01). On average, eGA by TCD was 0.9days less than that estimated by EUS (95% LOA +/-12.5d, 95% CI -1.69 - 0.51) with eGA by TCD showing the most agreement with that of EUS, (p < 0.01).

Conclusion: TCD is an accurate parameter in GA estimation, it remains accurate in aberrant fetal growth and in various BMI categories. TCD is a better predictor of GA in late pregnancy compared to standard parameters

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