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. 2015 Oct;9(10):TC01-5.
doi: 10.7860/JCDR/2015/14079.6554. Epub 2015 Oct 1.

Efficacy of Transcerebellar Diameter/Abdominal Circumference Versus Head Circumference/Abdominal Circumference in Predicting Asymmetric Intrauterine Growth Retardation

Bhimarao  1 , Rashmi M Nagaraju  2 , Venkataramana Bhat  3 , Puttanna Vn Gowda  4
Affiliations

Efficacy of Transcerebellar Diameter/Abdominal Circumference Versus Head Circumference/Abdominal Circumference in Predicting Asymmetric Intrauterine Growth Retardation

Bhimarao et al. J Clin Diagn Res. 2015 Oct.

Abstract

Background: The high incidence of IUGR and its low recognition lead to increasing perinatal morbidity and mortality for which prediction of IUGR with timely management decisions is of paramount importance. Many studies have compared the efficacy of several gestational age independent parameters and found that TCD/AC is a better predictor of asymmetric IUGR.

Aim: To compare the accuracy of transcerebellar diameter/abdominal circumference with head circumference/abdominal circumference in predicting asymmetric intrauterine growth retardation after 20 weeks of gestation.

Materials and methods: The prospective study was conducted over a period of one year on 50 clinically suspected IUGR pregnancies who were evaluated with 3.5 MHz frequency ultrasound scanner by a single sonologist. BPD, HC, AC and FL along with TCD were measured for assessing the sonological gestational age. Two morphometric ratios- TCD/AC and HC/AC were calculated. Estimated fetal weight was calculated for all these pregnancies and its percentile was determined.

Statistical methods: The TCD/AC and HC/AC ratios were correlated with advancing gestational age to know if these were related to GA. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA) for TCD/AC and HC/AC ratios in evaluating IUGR fetuses were calculated.

Results: In the present study, linear relation of TCD and HC in IUGR fetuses with gestation was noted. The sensitivity, specificity, PPV, NPV & DA were 88%, 93.5%, 77.1%, 96.3% & 92.4% respectively for TCD/AC ratio versus 84%, 92%, 72.4%, 95.8% & 90.4% respectively for HC/AC ratio in predicting IUGR.

Conclusion: Both ratios were gestational age independent and can be used in detecting IUGR with good diagnostic accuracy. However, TCD/AC ratio had a better diagnostic validity and accuracy compared to HC/AC ratio in predicting asymmetric IUGR.

Keywords: Fetal cerebellum; Gestational age; Growth restriction; Ultrasound.

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Figures

[Table/Fig-1]:
[Table/Fig-1]:
Grade I cerebellum. The cerebellum is seen between the calipers
[Table/Fig-2]:
[Table/Fig-2]:
Grade II cerebellum. The cerebellum is seen between the calipers
[Table/Fig-3]:
[Table/Fig-3]:
Grade III cerebellum. The cerebellum is seen between the calipers
[Table/Fig-4]:
[Table/Fig-4]:
Head circumference (HC) measurement
[Table/Fig-5]:
[Table/Fig-5]:
Abdominal circumference measurement
[Table/Fig-9]:
[Table/Fig-9]:
Scatter graph showing variation of TCD in advanced pregnancies (beyond 20 weeks) among IUGR fetuses
[Table/Fig-10]:
[Table/Fig-10]:
Scatter graph showing variation of HC in advanced pregnancies (beyond 20 weeks) among IUGR foetuses.
See this image and copyright information in PMC

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