First-Trimester Crown-Rump Length and Embryonic Volume of Fetuses with Structural Congenital Abnormalities Measured in Virtual Reality: An Observational Study

Abstract

Background. With the introduction of three-dimensional (3D) ultrasound it has become possible to measure volumes. The relative increase in embryonic volume (EV) is much larger than that of the crown-rump length (CRL) over the same time period. We examined whether EV is a better parameter to determine growth restriction in fetuses with structural congenital abnormalities. Study Design, Subjects, and Outcome Measures. CRL and EV were measured using a Virtual Reality (VR) system in prospectively collected 3D ultrasound volumes of 56 fetuses diagnosed with structural congenital abnormalities in the first trimester of pregnancy (gestational age 7+5 to 14+5 weeks). Measured CRL and EV were converted to z-scores and to percentages of the expected mean using previously published reference curves of euploid fetuses. The one-sample t-test was performed to test significance. Results. The EV was smaller than expected for GA in fetuses with structural congenital abnormalities (−35% p < 0.001, z-score −1.44 p < 0.001), whereas CRL was not (−6.43% p = 0.118, z-score −0.43 p = 0.605). Conclusions. CRL is a less reliable parameter to determine growth restriction in fetuses with structural congenital abnormalities as compared with EV. By measuring EV, growth restriction in first-trimester fetuses with structural congenital abnormalities becomes more evident and enables an earlier detection of these cases.

Accelerated fetal growth in early pregnancy and risk of preterm birth: a prospective cohort study

“…One possible explanation of this finding is the exclusion of pregnancies with fetal aneuploidy, congenital anomalies and fetal demise from the study population according to study design. Since the prior conditions have been associated to delayed fetal growth [14][15][16], it is not surprising that this exclusion might deflate the expected rates of preterm birth in this subgroup of fetuses. The incidence of preterm birth estimated in our study is in accordance with the reported national rates in Sweden and other Nordic countries [7,17,18].…”

Research on Improved NSGA-II Algorithm and Its Application in Emergency Management

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“…Thus the emergency facility location is a multiobjective optimization problem which has to take quantities of complex factors into consideration, while the evolutionary algorithms such as GA [9], PSO [10], NSGA [11], and MOEA/D [12] are usually applied to solve such kind of problems. Gadhvi et al [13] presented a constrained multiobjective optimization problem which is solved by NSGA-II, SPEA2, and PESA-II; the results show that NSGA-II is able to yield a better Pareto front.…”

Ultrasound Comparative Study between Trans-cerebellar Diameter with Bi-parietal Diameter and Femur Length for Gestational Age Measurement in Second Trimester of Pregnancy

“…During first trimester of pregnancy, crown rump length (CRL) and embryonic volumes measurements are considered as reliable elements in detecting the gestational age 4 .…”