Fetal transcerebellar diameter measurement with particular emphasis in the third trimester: A reliable predictor of gestational age

Objective

The purpose of this study was to validate prospectively a previous retrospectively established nomogram for the prediction of gestational age using transcerebellar diameter, especially in the third trimester.

Study design

In a previous study, we retrospectively constructed a cross-sectional nomogram using transcerebellar diameter measurements in 24,026 well-dated singleton fetuses. In the present study, this nomogram was validated prospectively on the basis of patients who were seen between August 2002 and May 2003 and who were carrying non-anomalous and non-malformed singleton gestations between 14 and 42 weeks (n=2597 gestations). The actual gestational age was then subtracted from the predicted gestational age, and the concordance between actual and predicted gestational ages was assessed based on the Pearson correlation (r).

Results

Concordance between the actual and predicted gestational age was high (r=0.92; P < .0001). This agreement was superior in the second trimester (r=0.93; P < .0001) than in the third trimester (r=0.81; P < .001). Between 17 and 21 weeks, and between 22 and 28 weeks of gestation, the predicted gestational age ranged between 0 and 4 days, and between 0 and 2 days, respectively, of actual gestational age. Between 29 and 36 weeks of gestation, predicted gestational age was within 5 days of actual gestational age; at 37 weeks of gestation, the predicted gestational age was discrepant by 9 days.

Conclusion

This prospective study demonstrates that transcerebellar diameter measurement is an accurate predictor of gestational age, even in the third trimester of pregnancy.

Key words: Cerebellum, Ultrasound evaluation, Gestational age, Nomogram, Validation