Ultrasonographic Measurement of Distal Femoral and Proximal Tibial Epiphyseal Ossification Centers in the Third Trimester and their Correlation to Gestational Age

Madkour, Nadia M.; Soliman, Badeea S.; Hussein, Dalia Zakareya; El-Massarawy, Ahmed Hassan

doi:10.21608/ejhm.2023.288373

Ultrasonographic Measurement of Distal Femoral and Proximal Tibial Epiphyseal Ossification Centers in the Third Trimester and their Correlation to Gestational Age

Document Type : Original Article

Authors

10.21608/ejhm.2023.288373

Abstract

Background: Sonographic estimations are derived from calculations based on fetal measurements and thus, serves as an indirect indicator of maturity and GA. Objective: This study aimed to measure the distal femoral (DFOC) and proximal Tibia (PTOS) epiphyseal ossification centers in the 3^rd trimester and correlate them to BPD, HC, AC, FL and GA to increase the ultrasound accuracy of gestational age (GA) estimation and thus avoiding iatrogenic prematurity.
MethodS: A prospective observational cohort study. A total of 150 low risk pregnant women. The Distal Femoral and the Proximal Tibia epiphyseal ossification centers were measured and correlate them to BPD, HC, AC, FL and GA.
Results: The best cut-off of DFOC in prediction of maturity (GA ≥ 37^th weeks' gestation) was ≥ 4.4 mm with area under curve 0.88 (CI: 0.83 to 0.94) with sensitivity 82.8%, specificity 79.3%, positive predictive value (PPV) 95%, negative predictive value (NPV) 49% and overall accuracy 80% (p < 0.001), the best cut-off of PTOC in prediction of maturity (GA ≥ 37^th weeks' gestation) was ≥ 2.5 mm with area under curve 0.887 (CI: 0.83 to 0.95) with sensitivity 82.8%, specificity 74.4%, positive predictive value (PPV) 95%, negative predictive value (NPV) 44% and overall accuracy 76% (p < 0.001). Conclusion: There was a strong positive correlation between DFOC, PTOC and GA.

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