The placenta is a meterno-fetal organ and starts developing on the 5th week from chorionic villi at the implantation site. The placenta continues to increase in thickness and hence its thickness can be used to indicate the gestational age when the last menstruation date is not confirmed. The purpose of the study was to find out the correlation of placental thickness to the gestational age estimated by growth parameters of the fetus. The study was a cross-sectional analytical study conducted on 2000 participants. The study was conducted in the Department of Radiology Social Security Hospital, Multan Chungi Lahore. The inclusion-exclusion criteria were established and participants were observed using a Toshiba ultrasonography machine. The subjects were placed supine and placental thickness was measured to the accuracy of 1mm. Pearson’s correlation was applied to find out the correlation between placental thickness and gestational age of the participants. The mean age of the participants was 28.37  +  4.6. The youngest participant was age 18 and the eldest participant was age 40. The gestational age of the participants included ranged between 12th week to 40th week. Pearson’s correlation score indicated that the correlation value 0.896. Which indicated that the placental thickness and gestational age were strongly correlated? The P-value < 0.05 indicated that the results were significant. The study concluded a strong correlation between gestational age and placental thickness of the fetus. The thickness of the placenta increased with an increase in gestational age and hence could be used as a predictor and a parameter of gestational age prediction when the last menstruation is uncertain or is unknown.

The estimation of G. age is vital part of obstetrical ultrasound examination for managing the pregnancy as well as monitoring the growth of the fetus. FFL measurement is a precise method for the calculation of the G.age of the fetus when other methods do not give accurate measurement. Objectives: The main objective of our review is to assess the role of ultrasonographic measurement of foot of the fetus in the calculation of G. age and secondary objective is to measure the FL to FFL ratio in the normal fetuses.  Methods: We conducted the systemic review with the help of following search engines and websites: Google scholar, NCBI, Medline and Medscape databases, Research gate, Science direct, PubMed, Global Health Library, Web of Science, Cochrane, from 1987-2019. Only those studies were included in this review that reported on the determination of the G. age from the FFL measurements on antenatal ultrasonography and on at least one statistic assessing the accuracy of gestational age estimation. The duplicate, non-English and incomplete studies were excluded. After initial screening of 120 studies only 20 studies were eligible for inclusion. All data extracted from them was analyzed using SPSS version 24. Results: After fulfilling eligibility criteria, we were left with 20 studies between years 1987 to 2019. Majority of the studies were conducted in Asia (60%) with study population greater than 50 participants (95%).All of our studies measured FFL for estimation of GA in singleton (80%) and normal (90%) pregnancies. Studies varied in their use of GA reference method, (5%) studies used LMP alone, (10%) studies relied on EDS, (10%) studies used either EDS or LMP as a comparison method, (45%) studies used both EDS and LMP and (30%) studies did not report their reference method. Ten studies reported R with mean value of 0.90002 and SD of 0.073997, 13 studies reported R2 with mean value of 0.85192 and SD of 0.156988. Six studies (38%) measured FL to FFL ratio with mean value of 0.96.Fifteen studies reported regression coefficient with mean value of 1.39057 and SD of 1.15890. Conclusions: After reviewing literature of 20 studies it was concluded that FFL is a precise method for the calculation of GA of the fetus. FFL is equally reliable when used with other ultrasonographic parameters as well as when used alone. FFL is also reliable for predicting the estimated FW in the last trimester of pregnancy. FL/FFL is useful in the detection of fetal skeletal dysplasia.

The Cesarean section (CS) delivery is a most frequent surgical technique worldwide. The CS increasing rate and its related problems have drawn an attention towards CS related morbidity. As recommended by WHO, C-section could be carried out only when required medically. In mid-pregnancy cervical extended length predicts the probability of CS early in the pregnancy. The objective of the study is to find the predictive accuracy of cervical length (CL) on transabdominal ultrasound for cesarean section in mid trimester taking mode of delivery as gold standard. It was a cross sectional study in which 362 females were enrolled. Females were undergoing transabdominal ultrasonography for assessment of cervical length. A 2x2 contingency table was generated to calculate sensitivity, specificity, positive predictive valve (PPV), negative predictive value (NPV) and diagnostic accuracy of transabdominal ultrasound taking actual mode of delivery as gold standard. The mean age of the females was 27.92 + 5.75 years while mean parity and mean CL were 2.22 + 1.30 and 35.83 + 7.96 mm, respectively. Among 30 females who had cervical length <25 mm, 24 had CS and 6 had spontaneous vaginal delivery (SVD). Among 332 females who had cervical length >25 mm, 96 had CS and 236 had SVD. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of transabdominal ultrasound for cesarean section were 20.0%, 97.5%, 80.0%, 71.1% and 71.8%, respectively. Study concluded that cesarean section takes place among pregnant females when cervical length is ≤25mm on transabdominal ultrasound during mid trimester.