Introduction: An accurate determination of the gestational age and the expected date of delivery is fundamental to the successful management of pregnancies specially in fetal growth restriction. In Fetal Growth Restricted (FGR) fetuses, there is a huge discrepancy in gestational age by last menstrual period and per abdominal obstetric findings, which gets even worse when the lady is not sure of her last menstrual period. Currently there is no available third trimester ultrasound parameter which can predict gestational age accurately and one such parameter which remains unaltered even by Fetal Growth Restricted Fetuses (FGR) should solve the therapeutic dilemma of the obstetrician and hence nullify the probability of iatrogenic prematurity. There are studies on fetal kidney length and transverse diameter of the heart alone can be used to predict the gestational age in third trimester with normal pregnancy. But for the FGR fetuses, we did not come across any such parameter to estimate the gestational age at third trimester. The present study was done to determine whether fetal kidney length and transverse diameter of the heart can be used to estimate the gestational age in case of growth restricted fetuses. In third trimester of pregnancy.

Methodology: It is an observational cohort study carried out in the department of Obstetrics & Gynaecology, NEIGRIHMS in collaboration with the department of Radiology from January 2016 to January 2018. A total number of 70 women with singleton pregnancy with spontaneous conception and excellent dates and diagnosed as small for gestational age clinically and ultrasonologically were included for the study. In our present study we included cases of FGR in third trimester having excellent dates and subjected them for conventional biometry for dating and at the same time measured fetal kidney length and fetal transverse diameter of heart for dating of pregnancy. The obtained data were recorded in Microsoft Excel sheet and analysed to obtain PEARSON Correlation coefficient and prediction of p value by using SPS SOFTWARE 21 VERSION.

Observation: In our study fetal  kidney length  was found to be the superior parameter to estimate the gestational age in growth retarted fetuses (r²-0785 and p value<0.0001). Next parameter was transverse diameter of fetal heart which can accurately estimate the gestational age in growth retatded fetuses (r²-0.4686and p value<0.0001). Amongst the conventional parameters femur length was most accurate (r²-0.3080, p value <0.0001). Other conventional diameters like BPD, HC, AC and combined parameter did not correlate with the gestational age calculated from LMP or CRL in first trimester ultrasound.

CONCLUSION: Fetal kidney length can be used as a reliable parameter to estimate the gestational age in growth retarded pregnancies where all the conventional ultrasonological parameter fails to estimate the gestational age accurately.

Key words- Fetal growth restriction; conventional USG parameter; Fetal kidney length; Transverse diameter of fetal heart. 

KEY WORDS:  Letrozole, Clomiphene Citrate, Ovulation Induction, Intrauterine Insemination.

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