Segmentation and Estimation of Fetal Biometric Parameters using an Attention Gate Double U-Net with Guided Decoder Architecture

Objective To quantitatively study the correlation of the distance of pulmonary valve to pulmonary artery bifurcation (DPVB) of normal fetuses in second and late trimester with the fetal biometric parameters using fetal echocardiography. Methods The distances of pulmonary valve to pulmonary artery bifurcation in end-systole (DPVBs) and in end-diastole (DPVBd) were measured in a standard short axis view or right ventricular outflow tract view using fetal echocardiography on 419 normal fetuses. The gestation ages ranged from 20 to 35+ weeks. Fetal non-cardiac biometric parameters including biparietal diameter (BPD), femoral length (FL) and gestation age (GA) based on menstrual age, pulmonary valve annulus diameters (PA) at end-systole were measured. The correlation between DPVBs, DPVBd and non-cardiac biometric parameters were analyzed. Results In normal fetuses, the DPVBs was (1.14±0.24)cm with a range of 0.67 to 1.61 cm, the DPVBd was (0.93±0.20)cm with a range of 0.53 to 1.33 cm. The DPVBs and DPVBd were increased with the growth of GA, and were positively correlated with GA, BPD, FL and PA (r=0.827, 0.798, 0.793, 0.769; 0.802, 0.764, 0.773 and 0.771, respectively, all P<0.001). The linear regression equations between DPVBs, DPVBd and GA, BPD, FL, PA were: Y=0.054×GA-0.369, Y=0.184×BPD-0.179, Y=0.217×FL+ 0.011, Y=1.602×PA+ 0.156, Y=0.045×GA-0.330, Y=0.152×BPD-0.157, Y=0.182×FL-0.018, Y=1.380×PA+ 0.080. Conclusions In normal fetuses, the DPVBs and DPVBd increase with the growth of GA, and have good correlation with GA, BPD, FL and PA, respectively. Normal reference ranges of DPVBs and DPVBd have been provided. These normative data may become a new tool for assessment of fetal heart, especially has potential applications in screening of complex congenital heart defects. Key words: Echocardiography; Fetus; Developmental biology; Distance of pulmonary valve to pulmconary artery bifurcation

Context: Pregnant women in India are often unable to recall the last menstruation period (LMP) and also present in the late trimester. In India, to determine the fetal age by ultrasonography (USG), Western nomogram is being used, but the racial and ethnic variation might lead to variation in estimation of fetal parameter. Aim: The aim of this study was to estimate the value of different fetal biometric parameters by USG and to compare it with Western nomogram like Hadlock’s. Settings and Design: This was a descriptive cross-sectional study. Subjects and Methods: The study was performed among 150 pregnant women in their second or third trimester following the inclusion and exclusion criteria. Statistical Analysis Used: The data were analyzed with Microsoft Excel and SPSS (Statistical Package for the Social Sciences) version 22.0. Results: 51.33% of participants were in 29–37 weeks of pregnancy. A statistically significant high positive linear correlation within the estimates of different sonological parameters was found. The observed coefficient of correlation for different parameters was as follows: biparietal diameter (r = 0.968), head circumference (r = 0.963), abdominal circumference (r = 0.964), and femur length (r = 0.963). In the same gestational age (GA), Hadlock’s chart reported higher diameter(s)/length, and differences were noted to be statistically significant. GA estimated by Hadlock’s chart was found to be significantly lower than that of the GA determined from LMP. Conclusion: The biometric sonological fetal parameters in the present study were significantly different from the Hadlock’s chart which notes a considerably higher reading for the same GA, indicating that the probability of race, ethnicity, and sample size played a role.

We sought to establish normative data for fetal liver volume (FLV) between 27 and 38 weeks' gestation using three-dimensional ultrasonography. The study design was a longitudinal prospective study involving 53 participants. A total of 250 FLV measurements were obtained, using the multiplanar method with 3.0-mm intervals. Polynomial regressions with adjustments using the determination coefficient ( R2) were used to assess the correlation between FLV and gestational age (GA) and fetal parameters (biparietal diameter, head circumference, abdominal circumference, and estimated fetal weight). The mean, standard deviation, and median, minimum, and maximum values were calculated for each gestational age. The intraclass correlation coefficient (ICC) was used to determine inter- and intraobserver reliability. There was a high correlation between FLV and GA. The mean FLV went from 43.5 +/- 7.6 cm (3) (29.1 to 62.2 cm (3)) to 130.5 +/- 20.1 cm3 (87.5 to 191.1 cm3). There was a high correlation between FLV and all fetal biometric parameters (all P < 0.0001). Intraobserver and interobserver correlations were excellent with an ICC = 0.993 and 0.984, respectively. There was a high correlation between GA and biometric parameters. Reference limits were generated for FLV between 27 and 38 weeks. FLV is highly reproducible.

A system-on-chip solution for deep learning-based automatic fetal biometric measurement

604: Fetal biometry to predict labor dystocia indicated term primary cesarean delivery: NICHD fetal growth studies

Transvaginal fetal biometry in early pregnancy.

Determination of fetal age during the fetal period Aim: The aim of this study was to determine the fetal age according to crown rump length (CRL), head circumference (HC), bi-parietal diameter (BPD), femur length (FL) and foot length (FtL) during the fetal period. Material and Methods: Two hundred and thirty five (male:120, female:115) fetal morphometric parameters were obtained from human fetuses aged between 6-40 weeks of gestation in this study. The fetal dimension parameters (CRL, HC, BPD, FL and FtL) of the fetuses were measured. The fetal ages were determined according to each fetal parameter. Findings: Means and standard deviations of the all parameters with respect to gestational weeks, trimester and months groups were calculated. No significant differences were observed between sexes for any of the parameters (p>0.05). All parameters were increasing with age during fetal period. There was significant correlation between gestational age and all parameters (p<0.001). There were differences between the gestational ages of each fetal parameter. The correlation coefficients of gestational ages according to fetal parameter were different between trimester groups. Conclusion: New data are derived to evaluate gestational age for human fetuses. Data acquired from this study is believed to contribute for studies of obstetrics, perinatology, forensic medicine and fetal pathology on fetal development, and diagnosis of its anomalies, pathologies and variations.

Background: As pregnancy progresses, the effectiveness of current methods for estimating gestational age diminishes. Meanwhile, fetal kidney length and placental thickness typically increase linearly with advancing gestational age. This observational study aims to explore whether fetal kidney length and placental thickness can serve as reliable indicators for estimating gestational age in healthy singleton pregnancies. This was a prospective observational study in which 125 patie Methodology: nts who came for regular antenatal checkup after 20weeks of gestation has undergone antenatal ultrasound examination were included on the basis of a predefined inclusion and exclusion criteria. First gestational age estimation was done using fetal biometry (head circumference, biparietal diameter, abdominal circumference and femur length). To measure fetal kidney length, the ultrasound transducer was first oriented longitudinally along the fetal spine. A slight adjustment in angulation allowed visualization of the paravertebral plane, capturing the complete length of each fetal kidney separately. Measurements were then averaged for accuracy. Placental thickness was assessed at its thickest point, typically near the umbilical cord insertion site. The correlation between placental thickness and gestational age, and between fetal kidney length and gestational age, was evaluated using biometric measurements and analyzed using Pearsons correlation coefficient. P value less than 0.05 was taken as statistically significant. In our study, the fetal kidney length and placental thickness correlated Results: well with assigned gestational age. A positive linear relationship of gestational age with fetal kidney length and placental thickness was found. Correlation of gestational age with fetal kidney length and placental thickness was 0.966 and 0.966 respectively. In conclusion, the study's Conclusion: results confirm the efficacy of using fetal kidney length (FKL) and placental thickness measurements as reliable indicators for estimating gestational age. These ultrasound measurements have proven accurate in adverse sample, enhancing the potential for widespread application in prenatal care. By enabling precise gestational age estimation, these biometric parameters can improve the timing of prenatal interventions, potentially reducing the risk of premature births and optimizing neonatal outcomes. The findings highlight the importance of integrating these measurements into routine prenatal screening protocols, suggesting that they could significantly enhance the quality and effectiveness of maternal and fetal health management. Despite challenges such as measurement variability due to operator dependency and the limitations of a cross-sectional study design, the study's impact is potentially transformative, particularly in settings where access to advanced prenatal care technologies is limited. Moving forward, further research should focus on longitudinal studies to track these measurements over time and refine the methodology to reduce variability and increase the reliability of these crucial prenatal assessments.

A table was generated, based on foetal ultrasonographic measurements in light breed mares, for each day of gestation beginning with day 100, to provide the predicted value of four biometric parameters: biparietal diameter (BPD), eye approximated volume (EyV), foetal aortic diameter (AortD) and femur length (FL). Using this table, day of gestation was successfully predicted in 23 Quarter Horses (QH) with known mating or ovulation dates. BPD, EyV and FL were the best foetal age predictors between 100- and 200-days gestation predicting within 2weeks of the actual day of gestation, while BPD and EyV were best between 200 and 300days (within 3weeks), and EyV was best after 300days (within 3weeks).

A comparison of fetal ultrasonographic biometric parameters of the head (head circumference - HC, biparietal diameter - BPD) in breech presented fetuses. Ultrasound biometry was performed in accordance with the method presented in the reference tables. In all breech presented fetuses, the HC, BPD and FL (femur length) were measured. High-risk and multiple pregnancies were excluded from the study. A total of 111 ultrasonographic biometries were performed between the 31(st) - 38(th) week of gestation. Fetuses in the breech position had a significantly lower BPD compared to HC and FL. The difference between BPD and HC was 16.2 days (95%Cl 14.3-18.1; p = 0.001). Maternal age at delivery was 20 - 36 years (average 28.1; median 28.0). According to our results, fetuses in the breech position have a significantly lower BPD compared to HC or FL. HC and FL parameters correlate with gestational age. In cases of ultrasonographic biometric discrepancy between BPD and FL, the fetal position should be taken into account. Breech-presented fetuses have an elongated head shape and ultrasound biometrics should evaluate its circumference (HC). It is important to responsibly interpret the results so as not to stress the expecting mother with suspicions of fetal pathology.

We aimed to determine the normal ranges for biorbital (BOD) and interorbital distances (IOD) during the second trimester in Turkish women with normal pregnancies and to assess the correlation between BOD, IOD, and other fetal craniofacial structures and biometric parameters. Our retrospective study comprised 1328 women with singleton normal pregnancies who had undergone ultrasonography (USG) examinations at 19-23 weeks of gestation in the second trimester screening. The measurements of BOD and IOD were obtained with the coronal section of the fetal face at the plane of orbits. Mean BOD was 3.4±0.33 cm, whereas mean IOD was 1.28±0.24 cm. Correlation analysis revealed that BOD was significantly correlated with IOD, transcerebellar diameter (TCD), cisterna manga (CM), nuchal fold (NF), nasal bone (NB), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), and gestational week. There was a significant relation between IOD and the lateral ventricle posterior horn, TCD, CM, NF, NB, BPD, HC, AC, and FL. The reference ranges obtained in our study enabled accurate evaluation of BOD and IOD in the second trimester of normal pregnancies. USG detection of fetal orbital biometric anomalies may alert the clinician for different anomalies associated with abnormal development of eye.

Background Every antenatal woman and her treating doctor aim for a healthy newborn. In obstetrics, accurately determining the gestational age (GA) is a critical aspect of managing pregnancy and evaluating fetal growth and development. The transcerebellar diameter (TCD) is the greatest transverse measurement of the fetal cerebellum. The growth of the cerebellum is minimally affected by fluctuations in growth, making the TCD the most reliable measurement for predicting GA. The purpose of the present research is to determine the accuracy of TCD in estimating GA in the second and third trimesters of pregnancy. Materials and methods The study included 500 antenatal women at 18-40 weeks of gestation. We also measured TCD in addition to routine ultrasoundparameters like biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). We used IBM SPSS Statistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States) for statistical analysis. The collected data was subjected to statistical tests, including Pearson's correlation coefficient and coefficient of determination. We conducted a regression analysis and used correlation coefficients to compare each ultrasound-measured parameter with the GA. Results The current research demonstrates a significant linear relationship between the TCD and GA (r = 0.9865; p = 0.0001), a strong association between BPD and GA (r = 0.9541; p = 0.0001), between HC and GA (r = 0.9613; p = 0.0001), between AC and GA (r = 0.9489; p = 0.0001), and between FL and GA (r = 0.9697; p = 0.0001). TCD showed the best correlation with GA among all the biometric parameters. TCD showed a correct assessment of GA by the last menstrual period (LMP) in 479 (95.8%) antenatal women. Conclusion The current research concludes that the TCD can be utilized as an independent measure to determine GA in the second and third trimesters of pregnancy, particularly in cases where the LMP is unknown, no dating scan has been performed in the first trimester, initial assessment taking place in the third trimester and in fetuses with variations in head shape such as dolichocephaly and brachycephaly.

Ultrasound (US) image segmentation methods, focusing on techniques developed for fetal biometric parameters and nuchal translucency, are briefly reviewed. Ultrasound medical images can easily identify the fetus using segmentation techniques and calculate fetal parameters. It can timely find the fetal abnormality so that necessary action can be taken by the pregnant woman. Firstly, a detailed literature has been offered on fetal biometric parameters and nuchal translucency to highlight the investigation approaches with a degree of validation in diverse clinical domains. Then, a categorization of the bibliographic assessment of recent research effort in the segmentation field of ultrasound 2D fetal images has been presented. The fetal images of high-risk pregnant women have been taken into the routine and continuous monitoring of fetal parameters. These parameters are used for detection of fetal weight, fetal growth, gestational age, and any possible abnormality detection.

Intrauterine Growth Restriction (IUGR) occurs when a fetus fails to reach its growth potential. Ultrasound plays a key role in diagnosis by assessing fetal biometry, and estimated weight. Umbilical artery Doppler studies evaluate placental function, with abnormal findings like increased resistance or absent/reversed end-diastolic flow. Objective: To detect Intrauterine growth retardation in 2nd and 3rd trimester with fetal parameters and umbilical artery doppler. Methods: This descriptive cross-sectional research took place at Diagnostic centre, Combined Military Hospital, Lahore from September to December 2024. All eligible 130 females in 2nd and 3rd trimester had recruited excluding females with Polyhydromnias. The examination involved the use of a curvilinear transducer (3-5MHz). Non probability convenient technique was employed for data collection. IBM (SPSS) version 26.0 was used for data analysis. For inferential statistics, Chi square test was employed. Statistical p-value &lt;0.05 was considered as a significant value. Results: The study involved 130 pregnant women (mean age 28.82 ± 4.64), with 29.2% in the 2nd and 70.8% in the 3rd trimester. IUGR history (25.4%), gestational hypertension (50.8%), and diabetes (19.2%) were noted. IUGR was diagnosed in 52 cases with 3–6week growth delays. Abnormal PI values in all cases confirmed PI as a reliable marker. Conclusions: In conclusion, fetal biometric parameters (BPD, HC, AC, FL) below the 10th percentile indicated IUGR in over one-third of 2nd and 3rd trimester pregnancies, with growth lags of 15–43 days. Abnormal umbilical artery Doppler PI was present in all IUGR cases, highlighting PI as a consistent and reliable detection marker.

273: Excessive fetal growth within appropriate-for-gestational-age affects neonatal hypoglycemia and macrosomia in gestational diabetes mellitus