The gestational age and the serum human chorionic gonadotropin (hCG) at which an intrauterine pregnancy can be detected using transvaginal ultrasonography (TVU) is not known. In this study, ten pregnant women were serially scanned with TVU from the time of initial positive pregnancy test, to determine when an intrauterine sac greater than 2 mm, fetal pole greater than 2 mm, and fetal heart motion could be detected. A gestational sac was seen 34.8 +/- 2.2 days from the last menstrual period (LMP), at which time the hCG was 1398 +/- 155 mIU/ml of the International Reference Preparations (IRP) or 914 +/- 106 mIU/ml of the Second International Standard (second IS). A fetal pole was seen 40.3 +/- 3.4 days from the LMP when the hCG was 5113 +/- 298 mIU/ml of the IRP or 3783 +/- 683 mIU/ml of the second IS. Fetal heart motion was detected 46.9 +/- 6.0 days from the LMP when the hCG was 17,208 +/- 3772 mIU/ml of the IRP or 13178 +/- 2898 mIU/ml of the second IS. From these results, it can be concluded that transvaginal ultrasonography can detect an intrauterine gestation earlier than what has been previously reported with transabdominal ultrasonography.

Early Detection of Pregnancy with Transvaginal Ultrasound

Ultrasonographic measurement of the transcerebellar diameter for gestational age estimation in the third trimester

Background & Objectives: Estimation of the length of gestation is of paramount importance to obstetricians. The fetal cerebellum grows progressively along gestational period and transverse cerebellar diameter can be used as a new biometric parameter to assess the gestational age of fetus. This study was done to evaluate the accuracy transverse cerebellar diameter against other regularly measured parameters like biparietal diameter, head circumference, abdominal circumference and femur length in pregnant women between 15 to 40 weeks of gestation. Materials & Methods: In this study of 60 pregnant women between 15-40 weeks of gestation, all the parameters like biparietal diameter, head circumference, abdominal circumference, femur length and transverse cerebellar diameter were measured with ultrasonography. The measured values were then correlated with gestational age using regression coefficient. Results: Gestational age estimated by transverse cerebellar diameter (R 2 = 0.989; p < 0.001) had good predictive value which was comparable to gestational age estimated by biparietal diameter (R 2 =0.929; P < 0.01), head circumference (R 2 =0.964; P < 0.01), abdominal circumference (R 2 =0.931; P < 0.01) and fetal length (R 2 = 0.966; P < 0.01).  Conclusion: Transverse cerebellar diameter has a good predictive accuracy for gestational age estimation which is comparableto other routinely used parameters and can be used as an alternative parameter to predict the gestational age.

pdf/accuracy-of-transverse-cerebellar-diameter-by-2914mexans.pdf

Accuracy of transverse cerebellar diameter by ultrasonography in the evaluation gestational age of fetus

Abnormal, difficult and prolonged labour is associated with an increased maternal and neonatal risk of complications. This is especially apparent in developing countries with limited healthcare resources where the risk of losing either mother or child or, worse still, both is particularly high. Although the safety and utility of diagnostic ultrasound appear no longer to be in much debate, benefits in routine obstetric care continue to provoke discussion. This chapter reviews the indications and contemporary practice of labour and delivery ultrasound with particular reference to developing countries in this regard. It concludes by further exploring the clinical utility and examining some of the limitations, followed by a review of its possible future applications.

Ultrasound in Labour and Delivery

Evidence Based Global Health Manual for Preterm Birth Risk Assessment

Objective : To compare the predictive accuracy of foetal trans-cerebellar diameter(TCD) with those of other biometric parameters in the estimation of gestational age (GA). Design : A cross-sectional study. Setting : The University of Benin Teaching Hospital, Nigeria. Subjects : Four hundred and fifty healthy singleton pregnant women, between 14-42 weeks gestation. Main Outcome measures : trans-cerebellar diameter (TCD), biparietal diameter (BPD), femur length (FL), abdominal circumference (AC) values across the gestational age range studied. Correlation and predictive values of TCD compared to those of other biometric parameters. Results : The range of values for TCD was 11.9 -59.7mm (mean =34.2±14.1mm). TCD correlated more significantly with menstrual age compared with other biometric parameters (r=0.984, p=0.000). TCD had a higher predictive accuracy of 96.9%±12 days), BPD (93.8%±14.1days). AC (92.7% ± 15.3days). Conclusion : TCD has a stronger predictive accuracy for gestational age compared to other routinely used foetal biometric parameters among Nigerian Africans.

/pdf/predictive-accuracy-of-transcerebellar-diameter-in-4zjqzisdyo.pdf

Predictive accuracy of transcerebellar diameter in comparison with other foetal biometric parameters for gestational age estimation among pregnant nigerian women.

Introduction: Tropical calcific pancreatitis is known to be associated with malnutrition and insulin-requiring diabetes mellitus. Recent studies suggest that genetic and environmental factors play a role in its etiopathogenesis. Objective: The objectives of this was were to study the prevalence, profile, and outcome of children managed for type 1 diabetes mellitus with pancreatic calcification. Materials and Methods: This was a cross-sectional study of children managed for type 1 diabetes mellitus in the pediatric endocrine unit of Federal Teaching Hospital Abakaliki, Nigeria. All patients who consented underwent ultrasonography of the pancreas. We undertook a case note review to identify factors that may be associated with pancreatic calcification. Results: Thirty-seven children were diagnosed with diabetes mellitus. The mean age was 12.3 years (5–17 years), 21 males and 16 females. Twenty of 37 (54.1%) patients were screened for pancreatic calcifications using abdominal ultrasound. Seventeen of 37 were not studied as nine of them (24.3%) died, six lost to follow-up, and two declined to participate. The mean duration of diabetes mellitus was 2.7 years (3 months–8 years). All patients were managed with a premixed twice-daily insulin regimen. Pancreatic calcification was seen in seven out of the 20 (35%) and was commoner among males and older children. The average glycosylated hemoglobin (Hba1c) was 13 and 11, and average height/weight standard deviation score was –1.9/–1.9 and –1.03/–1.02 in those with calcification and those without, respectively. Conclusion: Tropical calcific pancreatitis is common among children diagnosed with diabetes mellitus in Abakaliki, Nigeria and is associated with morbidity. Routine pancreatic ultrasound of patients with type 1 diabetes mellitus may be necessary.

Pancreatic Calcification among Children with Childhood Diabetes in Abakaliki, Nigeria: Could This Be Fibrocalculous Pancreatic Diabetes?

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Predictive accuracy of transcerebellar diameter in comparison with other foetal biometric parameters for gestational age estimation among pregnant nigerian women.

Pancreatic Calcification among Children with Childhood Diabetes in Abakaliki, Nigeria: Could This Be Fibrocalculous Pancreatic Diabetes?