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© 2007 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 26:1167-1171 • 0278-4297

Fetal Transcerebellar Diameter Measurement for Prediction of Gestational Age at the Extremes of Fetal Growth

Martin R. Chavez, MD, Cande V. Ananth, PhD, MPH, John C. Smulian, MD, MPH and Anthony M. Vintzileos, MD

Divisions of Maternal-Fetal Medicine (M.R.C., J.C.S., A.M.V.) and Epidemiology and Biostatistics (C.V.A.), Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, New Brunswick, New Jersey USA.

Address correspondence to Martin R. Chavez, MD, Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, 125 Paterson St, New Brunswick, NJ 08901-1977 USA. E-mail: chavez{at}umdnj.edu

Objective. The purpose of this study was to determine the accuracy of our previously published and prospectively validated transcerebellar diameter (TCD) nomogram in the prediction of gestational age (GA) in intrauterine growth-restricted (IUGR) and large fetuses. Methods. We established a cross-sectional nomogram of TCD in 24,026 well-dated singleton fetuses and prospectively validated the nomogram using 2597 fetuses from a separate population. This nomogram was validated in both IUGR (n = 55) and large (n = 16) fetuses (estimated fetal weight, <10th and >90th percentiles, respectively). The actual GA was subtracted from the TCD-predicted GA in IUGR and large fetuses, and the concordance between the actual and predicted GAs was assessed using the Pearson correlation coefficient. Results. Concordance between the actual and predicted GA based on our previously published singleton TCD nomogram was high for both IUGR and large fetuses (Pearson correlation, r = 0.98 and 0.95, respectively; P < .001). The means (SDs) of actual and predicted GA based on TCD in IUGR fetuses were 24.9 (6.5) and 25.1 (6.3) weeks, respectively. The predicted GA based on TCD in IUGR fetuses was within 3 days in 97.5% in the second trimester and 93.3% in the third trimester. In large fetuses, the difference between the actual and predicted GA based on TCD within 3 days was 100% in both the second and third trimesters. Conclusions. This study shows that our institution-specific TCD nomogram is reliable and accurate in predicting GA even at extremes of fetal growth.

Key Words: cerebellum • gestational age • intrauterine growth restriction • large fetuses • nomogram • sonography

Abbreviations: GA, gestational age • IUGR, intrauterine growth-restricted • TCD, transcerebellar diameter

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Copyright © 2007 by the American Institute of Ultrasound in Medicine.