Ultrasonographic Measurement of Distal Femoral and Proximal Tibial Epiphyseal Ossification Centers in the Third Trimester and their Correlation to Gestational Age
Madkour, N., Soliman, B., Hussein, D., El-Massarawy, A. (2023). Ultrasonographic Measurement of Distal Femoral and Proximal Tibial Epiphyseal Ossification Centers in the Third Trimester and their Correlation to Gestational Age. EKB Journal Management System, 90(2), 3009-3014. doi: 10.21608/ejhm.2023.288373
Nadia M. Madkour; Badeea S. Soliman; Dalia Zakareya Hussein; Ahmed Hassan El-Massarawy. "Ultrasonographic Measurement of Distal Femoral and Proximal Tibial Epiphyseal Ossification Centers in the Third Trimester and their Correlation to Gestational Age". EKB Journal Management System, 90, 2, 2023, 3009-3014. doi: 10.21608/ejhm.2023.288373
Madkour, N., Soliman, B., Hussein, D., El-Massarawy, A. (2023). 'Ultrasonographic Measurement of Distal Femoral and Proximal Tibial Epiphyseal Ossification Centers in the Third Trimester and their Correlation to Gestational Age', EKB Journal Management System, 90(2), pp. 3009-3014. doi: 10.21608/ejhm.2023.288373
Madkour, N., Soliman, B., Hussein, D., El-Massarawy, A. Ultrasonographic Measurement of Distal Femoral and Proximal Tibial Epiphyseal Ossification Centers in the Third Trimester and their Correlation to Gestational Age. EKB Journal Management System, 2023; 90(2): 3009-3014. 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

The Egyptian Journal of Hospital Medicine
Article 154, Volume 90, Issue 2, January 2023, Page 3009-3014  XML PDF (619.42 K)
Document Type: Original Article
DOI: 10.21608/ejhm.2023.288373
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Authors
Nadia M. Madkour; Badeea S. Soliman; Dalia Zakareya Hussein email ; Ahmed Hassan El-Massarawy
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 3rd 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 ≥ 37th 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 ≥ 37th 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.
 
Keywords
Ultrasound; Gestational age; Distal femoral; Proximal tibia; Ossification centers
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